隐匿性、复发性消化道出血34例的临床分析

目的探讨隐匿性、复发性消化道出血的诊断方法。方法回顾性分析34例隐匿性、复发性消化道出血的临床资料。结果肿瘤14例（41％）以良性肿瘤多见，感染性疾病10例（29％），憩室7例（20％），血管畸形3例（8％），本组病例均行药物止血，凝血酶作肠腔灌注后均复发，31例行手术治疗、3例行病变周围鱼肝油酸钠硬化荆注射均获痊愈。结论隐匿性、复发性消化道出血最常见于小肠肿瘤，感染性疾病、核素扫描憩室的阳性率高，选择性血管造影，加肝素及尿激酶灌注对血管病变及富含血管的病变有较高的诊断价值，肠道钡餐X线对实质性病变及憩室的诊断率较高，剖腹探查结合术中电子肠镜可以提高诊断率。

Update in management of mesenteric ischemia

Mesenteric ischemia disorders are precipitated by a circulation insufficiency event that deprives one or several abdominal organs of adequate respiration to meet metabolic demands. Although mesenteric ischemia occurs infrequently, the mortality rate is from 60% to 100%, depending on the source of obstruction. The successful outcome is dependent upon a high index of suspicion and prompt management. We briefly review the pathophysiology and presentation of the various ischemic entities and review the current state of the art in diagnosis and treatment. Despite advances in both diagnosis and treatment, prompt diagnosis and supportive care remain critical for successful outcome. New imaging techniques, endovascular therapy and emerging research may improve our approach to this deadly condition.