不明原因消化道出血的诊断和处理（Diagnosis and management of obscure gastrointestinal bleeding）.doc

不明原因消化道出血的诊断和处理（Diagnosis and management of obscure gastrointestinal bleeding） Obscure gastrointestinal bleeding (OGIB) is defined as the conventional endoscopy (gastroscopy and colonoscopy) and X-ray examination of small intestine (oral barium or barium enema) failed to identify the cause of hemorrhage of recurrent or persistent gastrointestinal bleeding. The definition has been modified for routine endoscopy (gastroscopy and colonoscopy) failed to identify the cause of hemorrhage of recurrent or persistent gastrointestinal bleeding. According to the dominant (overt) and recessive (occult) characteristics of hemorrhage, two types can be divided into unknown causes, one recessive hemorrhage and one unknown dominant bleeding. The diagnosis and treatment of OGIB was one of the world facing challenges. The digestive clinicians in recent years with the advent and application of capsule endoscopy and double balloon enteroscopy etc. a new generation of endoscopy, the diagnosis and treatment level has been greatly improved. I. etiology The cause of OGIB can be any lesion from the esophagus to the rectum with intraluminal hemorrhage. The traditional gastrointestinal bleeding is classified according to the site, and the Treitz ligament is divided into upper gastrointestinal bleeding and lower digestive tract bleeding. The advantages of this classification is as manifestations of hematemesis of upper gastrointestinal bleeding, which can reduce the scope of inspection. Advances in gastrointestinal endoscopy have made it possible to classify gastrointestinal bleeding according to the site of endoscopic examination. This classification classifies OGIB into upper, middle, and lower gastrointestinal bleeding. Gastroscopy can peep to duodenal ampulla of Vater bleeding is the upper gastrointestinal hemorrhage; ampulla of Vater to the terminal ileum by capsule endoscopy and (or) double balloon enteroscopy at best. The hemorrhage of the intestinal tract belongs to the middle digestive