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Small Bowel Refractory Bleeding: A Retrospective Study for Causes and Surgical Management
Ahmed A S Al-Magedi1, Yifan Xv1, Zhi Wang2
1Departments of General Surgery.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|February 2, 2023
Summary
Small bowel bleeding is common in elders. Intraoperative enteroscopy enterotomy (IOE-E) offers a safer surgical approach with lower morbidity and shorter operation times for refractory cases.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Medical Diagnostics
Background:
- Small bowel (SB) bleeding is a frequent gastrointestinal issue, especially in elderly populations.
- Refractory SB bleeding presents significant diagnostic and therapeutic challenges.
- Identifying the causes and optimizing surgical treatment for SB bleeding is crucial.
Purpose of the Study:
- To determine the causes of refractory small bowel bleeding.
- To evaluate the effectiveness and challenges of surgical interventions for SB bleeding.
- To compare different surgical approaches for managing SB bleeding.
Main Methods:
- Retrospective analysis of patients with refractory SB bleeding who underwent surgery.
- Review of patient characteristics, surgical findings, and follow-up data from October 2014 to November 2020.
- Comparison of intraoperative enteroscopy enterotomy (IOE-E) with IOE-combined approaches.
Main Results:
- Vascular lesions (29.6%) and tumors (24.5%) were the most common causes of SB bleeding.
- Diverticular bleeding was more prevalent in younger patients (<60 years), while vascular lesions were more common in older patients (≥60 years).
- IOE-E demonstrated significantly lower postoperative morbidity and shorter operation times compared to the IOE-combined method (P <0.05).
Conclusions:
- Patient age and detailed history aid in identifying the etiology of SB bleeding.
- Intraoperative enteroscopy enterotomy (IOE-E) is a safe and effective surgical technique.
- Close collaboration between surgeons and endoscopists is vital for successful management when initial diagnostic methods are inconclusive.
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