Korean J Gastrointest Endosc > Volume 37(5); 2008 > Article
Korean Journal of Gastrointestinal Endoscopy 2008;37(5): 321-327.
이중풍선소장내시경에서 활동성 소장 출혈을 보인 환자의 임상 고찰
이태희ㆍ김진오ㆍ은수훈ㆍ고봉민ㆍ조주영ㆍ이준성ㆍ진소영ㆍ이문성ㆍ심찬섭ㆍ김부성
순천향대학교 의과대학 내과학교실, 소화기연구소
A Clinical Analysis of Patients with Active Small Bowel Bleeding as Detected on Double Balloon Enteroscopy
Tae Hee Lee, M.D., Jin Oh Kim, M.D., Soo Hoon Eun, M.D., Bong Min Ko, M.D., Joo Young Cho, M.D., Joon Seong Lee, M.D., So Young Jin, M.D., Moon Sung Lee, M.D., Chan Sup Shim, M.D. and Boo Sung Kim, M.D.
Department of Internal Medicine, Institute for Digestive Research, Soonchunhyang University College of Medicine, Seoul, Korea
Abstract

Background/Aims:
There are few studies that have evaluated active small bowel bleeding. The aim of this study was to evaluate patients with active small bowel bleeding that had been considered as obscure gastrointestinal bleeding an was confirmed by the use of double balloon enteroscopy (DBE).
Methods:
We retrospectively reviewed the medical records of 12 patients with active small bowel bleeding as detected on DBE from January 2005 to September 2007.
Results:
The mean patient age was 63 years (age range, 45∼80 years) and the patients consisted of seven men and five women. The mean hemoglobin level at admission was 7.6 g/dL (range, 5.8∼9.0 g/dL). The mean transfusion volume was 4.4 pints (range, 0∼7 pints). Angiodysplasia was the most common cause of bleeding (n=6, 50%), followed by small bowel tumors (n=4, 33%). Other causes included diverticula and a nonspecific ulcer. The most common location of bleeding was the jejunum. Diagnostic yields of capsule endoscopy, a 99mTc RBC scan, an abdomen CT scan, angiography and a small bowel series were 40%, 33%, 25%, 0% and 0%, respectively. Endoscopic treatment was performed successfully in eight patients (67%).
Conclusions:
The most common etiology for active small bowel bleeding is angiodysplasia followed by a small bowel tumor. Other diagnostic methods for the small bowel showed low diagnostic yields. Further investigation of active small bowel bleeding is needed to confirm our results. (Korean J Gastrointest Endosc 2008;37:321-327)
Key Words: Double-balloon enteroscopy, Active bleeding, Angiodysplasia, Gastrointestinal stromal tumor, Diverticula
주요어: 이중풍선소장내시경, 활동성 출혈, 혈관이형성증, 위장관 간질종양, 게실
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