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DOI: 10.1055/s-0040-1704068
RESULTS OF THE EVALUATION OF CLINICAL MANIFESTATION OF SMALL INTESTINE BLEEDING AND ITS SOURCES
Publikationsverlauf
Publikationsdatum:
23. April 2020 (online)
Aims To evaluate sources of intestinal bleeding and compare their clinical features.
Methods From 14.02.2007 to 10.03.2019 229 patients (m-117, f-112, mean age 52,3±18,3 years, range 17-89) were admitted to our clinics with GIB of unknown source. Obscure overt bleeding had 142 (62,0%) pts, obscure occult bleeding - 87 (38,0%) pts, associated with severe anemia in 86 (37,5%) pts, moderate anemia - in 87 (37,9%) pts and mild anemia - in 56 (24,4%) pts. Other complaints were: abdominal pain in 50 (51,0%) pts, diarrhea in 26 (26,5%) pts, nausea/vomiting in 22 (22,4%) pts. Videocapsule enteroscopy was performed in 179 (78,2%) pts, balloon-assisted enteroscopy - in 146 (63,7%) pts.
Results The source of GIB was found in 191 (83,4%) pts: small bowel (SB) - in 170 (89,0%) pts; upper/lower GI tract - in 21 (11,0%) pts, no pathology - in 38 (16,6%) pts. The sources of SB bleeding included vessel malformations (VM) in 65 (35,7%) pts, tumors - in 54 (29,7%) pts, erosive/ulcerative enteropathy - in 42 (23,1%) pts, diverticula - in 9 (5,3%) pts (incl. Meckel’s diverticulum (6)). VM were more common in patients older than 55 years, tumors and enteritis - up to 55 (p=0.03700). Pts with VM and tumors predominantly had obscure overt bleeding, pts with enteritis - obscure occult bleeding (p=0.03795). The period of tumors detection was longer year, than the diagnosis of enteritis (p=0.00648). Having tumors and enteritis patients more often experienced abdominal pain, that those with VM (p=0.00049); pts with enteritis more often complained of diarrhea than pts with VM and tumors (p=0.00001). All pts with SB diverticula had overt GIB, apparent with severe anemia, without any other complaints.
Conclusions The knowledge about different clinical manifestation of certain sources of intestinal bleeding may be useful in complex diagnostics.