【摘要】 目的探讨不明原因下消化道出血的常见病因及诊断策略。方法回顾分析33例不明原因下消化道出血病人的临床资料。结果出血病因为:小肠肿瘤9例,小肠憩室病4例,肠系膜上静脉血栓形成2例,肠系膜上动脉栓塞3例及非闭塞性肠系膜缺血4例,Crohn病4例,溃疡性结肠炎5例,肠结核1例,小肠静脉扩张症1例。其中,复查结肠镜或钡灌肠明确诊断8例,64排CT及增强扫描诊断16例,DSA诊断2例,小肠气钡双重造影诊断4例,腹腔镜探查诊断2例,剖腹探查诊断1例。结论对于不明原因下消化道出血病人的诊断,复查结肠镜或钡灌肠是重要选择之一,64排CT扫描在无创检查中诊断率最高,DSA和腹腔镜探查虽然有创,但也是诊断的重要手段。更多还原

【Abstract】 Objective To explore the causes of obscure lower gastrointestinal hemorrhage(OLGIH) and diagnostic strategies.MethodsThe clinical data of OLGIH in 33 patients were retrospectively analyzed.ResultsThe causes of OLGIH were as follows:small bowel tumor(9 cases),diverticulosis(4 cases),mesenteric venous thrombosis(2 cases),mesenteric artery embolization(3 cases),nonocclusive mesenteric ischemia(4 cases),Crohn disease(4 cases),ulcerative colitis(5 cases),intestinal tuberculosis(1 case),small bowel vein phlebectasia(1 case).Diagnoses were confirmed by re-examination of colonoscope or barium clysis again in 8 cases,64-slice spiral CT scanning and contrast-enhanced scanning in 16 cases,DSA in 2 cases,small bowel air-barium double contrast examination in 4 cases,laparoscope in 2 cases,and exploratory laparotomy in 1 case.ConclusionFor detecting the cause of OLGIH,re-examination of colonoscope or barium clysis is an important choice.64-slice spiral CT scanning is the most effective way among no-invasive detections.DSA and laparoscope are important ways.更多还原