Analysis Of Causes And Clinical Diagnosis And Treatment Of 167 Cases Of Small Bowel Bleeding

Objective:The small intestine away from the mouth and anus,that has strong peristalsis and excess mobility.Bleeding from the small bowel remains relatively uncommon,accounting for 5~10%,its clinical symptoms lack specificity,the diagnosis and treatment of the disease in clinical work has always been blind.The objective of this study was to investigate the etiology and and features of small bowel bleeding,which may be improve the prognosis of SBDs and beneficial for the diagnosis and treatment of diseases.Methods:A retrospective study of clinical data of 167 patients with small bowel bleeding at the digestive and general surgery department of Shengjing Hospital of China Medical University from Novermber 2012 to October 2018 was performed.The etiology,lesion site,inspection method and treatment were analyzed.Results:Among 167 patients,108 were male,59 were female,ratio of 1.83:1,aged 14 to 96 years old,the average(49.10±17.48).The course ranged from 8 hours to 11 years,139 were overt bleeding,28 were occult bleeding.Among the 156 patients with clear etiology,the lesion in jejunum were 60,in ileum were 80,and 16 cases were all affected.Inflammatory diseases accounted for 35.33% of the patients,followed by tumors 30.54%,vascular diseases 17.96%,other benign lesions 9.58%,OGIB 4.79% and biliary/pancreatic hemorrhage 1.80%.Statistical analysis showed that there were significant differences in disease types among different age groups(p=0.005,x2=18.355),but no difference between male and female patients(p=0.343,X2=3.330).Different inspection methods had differences in positive rate of different causes.The diagnostic rate of CT for tumors is 85.1%,diagnostic yield of CE for vascular and inflammatory lesions is 69.2% and 88.6%,respectively,and that of DBE is about 66%,but the number of case is small.Of the 7 patients with intestinal vascular dysplasia treated with somatostatin analogues or thalidomide,6 cases recovered well.Most patients have a good prognosis after medical therapy and/or surgical.Conclusions:Inflammatory lesions,neoplasm were the most common etiology of small-bowel bleeding,followed by vascular lesions.The etiology of small bowel bleeding between the different age groups were not the same.Different inspection methods have different diagnostic role on small intestinal bleeding.Thalidomide and somatostatin analogues may be an option for patients with intestinal bleeding due to vascular dysplasia.Surgical intervention should be carried out as soon as possible for repeated bleeding with poor medical therapeutic effect and small intestinal neoplasms.