腹腔镜辅助内镜检查对小肠出血性疾病的诊断价值

The diagnostic value of endoscopy assisted with laparoscopy in patient with small intestinal bleeding

目的 探讨腹腔镜辅助内镜检查对小肠出血性疾病的诊断价值。方法 选择1994年～2002年间常规检查难以明确病因的16例小肠出血性疾病患者,行腹腔镜辅助内镜检查,病理学检查。结果 16例患者均完成腹腔镜辅助内镜检查。腹腔镜下直接发现病灶5例,联合应用内镜检查发现病灶11例;病理检查显示平滑肌肉瘤1例,平滑肌瘤4例,小肠腺瘤4例,黏膜下血管瘤2例,血管畸形和毛细血管扩张症2例,Meckel憩室炎伴出血3例。结论 腹腔镜辅助内镜检查对常规检查无法明确病因的小肠出血有较好的诊断价值。该技术方法简单、创伤小、病变阳性检出率高,有较好的临床推广价值。

Objective To study the diagnostic value of endoscopy assisted by laparoscopy in patients with small intestinal bleeding. Methods In case of small intestinal bleeding it is hard to define the accurate etiological factor by routine examination. From 1994 to 2002 there were 14 patients with chronic me-lena or persisted melena complicated with chronic anemia and 2 cases of acute alimentary tract hematorrhea complicated with obvious hypovolemia. Results Endoscopies assisted by laparoscopy were accomplished in all of the 16 cases. Lesions were detected in 5 cases with laparoscopy directly, and in 11 cases the pathological changes were discovered by endoscopies assisted with laparoscopy . The pathologic results were leiomyo-sarcoma 1 cases, leiomyoma 4 cases, adenoma of small intestine , hemangioma , vascular malformation and capillary telangiectasia 2 cases each, and Meckels diverticulitis with hemorrhage 3 cases. Conclusion The diagnostic value of endoscopy assisted with laparoscopy is superior to the routine examination in detecting the small intestinal bleeding. This technique has the advantage of simple, less-traumatic and high sensitivity. It is worthy to popularize in clinical practice.