肠镜检查
医学
胶囊内镜
氩等离子体凝固
背景(考古学)
内窥镜检查
血管发育不良
放射科
外科
生物
古生物学
作者
Stefania Chetcuti Zammit,Reena Sidhu
出处
期刊:Current Opinion in Gastroenterology
[Ovid Technologies (Wolters Kluwer)]
日期:2018-05-01
卷期号:34 (3): 165-174
被引量:17
标识
DOI:10.1097/mog.0000000000000429
摘要
The objective is to provide an overview on the cause of small bowel bleeding. We discuss the role of small bowel endoscopy in the management of small bowel bleeding and provide an outline of pharmacotherapy that can be additionally beneficial.Small bowel capsule endoscopy (SBCE) is the initial diagnostic investigation of choice in small bowel bleeding. Computed tomography (CT) can be helpful in the context of small bowel tumours. Device-assisted enteroscopy (DAE) enables several therapeutic procedures such as argon plasma coagulation (APC) and haemoclip application. It can also guide further management with histology or by marking culprit lesions with India ink. A persistent rate of rebleeding despite APC is increasingly being reported. Pharmacotherapy has an emerging role in the management of small bowel bleeding. Somatostatin analogues are a well tolerated class of drugs that can play an additional role in the management of refractory bleeding secondary to small bowel angioectasias.SBCE is useful in determining the cause of small bowel bleeding. DAE offers an endoscopic therapeutic approach to small bowel bleeding replacing surgery and intraoperative enteroscopy. Pharmacotherapy, in addition to endotherapy, can play an important role in the management of multifocal, recurring bleeding small bowel lesions.
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