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首页> 外文期刊>Gastrointestinal Endoscopy >Bleeding Dieulafoy lesions of the small bowel: a systematic study on the epidemiology and efficacy of enteroscopic treatment.
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Bleeding Dieulafoy lesions of the small bowel: a systematic study on the epidemiology and efficacy of enteroscopic treatment.

机译：小肠出血性Dieulafoy病变：对肠镜治疗的流行病学和疗效的系统研究。

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BACKGROUND: Dieulafoy lesions consist of aberrant submucosal arteries, which can cause severe GI bleeding. The predominant location of Dieulafoy lesions is the upper GI tract. OBJECTIVE: To our best knowledge, this is the first systematic study on the frequency of bleeding from Dieulafoy lesions in the small bowel and the efficacy of enteroscopic therapy regarding primary hemostasis and long-term follow-up. DESIGN: Multicenter, retrospective, observational study. SETTING: Nine Austrian centers doing double-balloon enteroscopy or single-balloon enteroscopy. PATIENTS: This study involved 284 consecutive patients who were referred for double-balloon enteroscopy or single-balloon enteroscopy because of suspicion of mid-GI bleeding. INTERVENTION: A total of 317 double-balloon enteroscopy and 78 single-balloon enteroscopy procedures were performed in 284 patients with suspected mid-GI bleeding. MAIN OUTCOME MEASUREMENTS: Demographic, clinical, procedural, and outcome data were collected. RESULTS: A Dieulafoy lesion in the small bowel was identified as the source of mid-GI bleeding in 3.5% of patients, with a mean of 1.5 enteroscopy sessions required per diagnosis. In 9 cases the Dieulafoy lesion was found by enteroscopy from an oral approach, and in 1 patient the lesion was found by an anal approach. In all patients primary endoscopic hemostasis was successful. Eight of 10 patients were free from rebleeding episodes (median follow-up 14.5 months, interquartile range 10.0-17.5 months). In 2 of 10 patients, rebleeding occurred, and a surgical intervention was necessary. LIMITATIONS: Retrospective study. CONCLUSION: Bleeding from Dieulafoy lesions of the small bowel seems to occur more frequently than previously estimated. Most of these lesions are located in the proximal jejunum and can be managed successfully by enteroscopy. After successful endoscopic hemostasis, rebleeding episodes occur in only 20% of patients.
机译：背景：Dieulafoy病变由粘膜下动脉异常组成，可引起严重的胃肠道出血。 Dieulafoy病变的主要位置是上消化道。目的：据我们所知，这是关于小肠Dieulafoy病变出血频率以及肠镜治疗对原发止血和长期随访的疗效的首次系统研究。设计：多中心，回顾性，观察性研究。地点：九个奥地利中心进行双气囊肠镜或单气囊肠镜。患者：这项研究涉及284位连续患者，他们因怀疑中胃肠道出血而接受了双气囊肠镜或单气囊肠镜检查。干预：284例怀疑中胃肠道出血的患者共进行了317次双气囊肠镜检查和78次单气囊肠镜检查程序。主要观察指标：收集人口统计学，临床，手术和结果数据。结果：在3.5％的患者中，小肠Dieulafoy病变被确定为胃肠道中段出血的来源，每个诊断平均需要进行1.5次肠镜检查。在9例中，通过口腔入路的肠镜检查发现Dieulafoy病变，在1例中，通过肛门入路发现了病变。在所有患者中，原发性内镜止血均成功。 10例患者中有8例没有再出血发作（中位随访时间为14.5个月，四分位间距为10.0-17.5个月）。 10例患者中有2例发生再出血，需要手术干预。局限性：回顾性研究。结论：小肠Dieulafoy病灶出血的发生率似乎比以前估计的高。这些病变大多数位于空肠近端，可通过肠镜检查成功治疗。内镜止血成功后，仅20％的患者发生再出血。

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