| Objectives:Small intestinal bleeding is a rare disease,The diagnosis and treatment of this disease are still difficult.This study compared the differences in the etiology,age and sex of small intestine hemorrhage in different regions and the advantages and disadvantages of various diagnostic methods for small intestinal bleeding.It can provide some suggestions for the diagnosis of small intestinal bleeding in future clinical work.Methods:A total of 176 patients with the diagnosis of small intestinal bleeding from Peking Union Medical College Hospital and Hong Kong University Shenzhen Hospital were retrospectively recruited from January 2013 to January 2019.We performed a restrospective analysis of the clinical relevant data information,including patient demographics,clinical performance,medical comorbidities,admission laboratory values,radiological data,and endoscopy results.Results:The mean age of the patients included in the study was 50.09±16.35 years.Among them,the proportion of young patients(18～44years)and elderly patients(≥60 years)were slightly higher than that of middle age(45～59 years),respectively 36.4%and 35.2%vs 26.1%.Small bowel angioectasias was the primary cause of small intestinal bleeding(38%).The main cause of small intestinal bleeding in elderly patientis were small bowel angioectasias(46.8%),small intestine ulcer/erosive(9.7%).In middle-aged patients,the main cause of small intestinal bleeding were small bowel angioectasias(32.7%),small intestine ulcers/erosive(14.3%),small intestine tumors(10.2%).In young patients the main cause of small intestinal bleeding were small bowel angioectasias(33.3%),small intestine ulcer/erosion(11.1%).The causes of small intestinal bleeding in Beijing and Shenzhen were different,but there was no statistical significance between age and sex(P>0.05).The diagnostic methods are similar.In the distribution of disease etiology,the middle-aged and young patients in Shenzhen are mainly due to small bowel tumors(33.33%of middle-aged,18.75%of young people),and the main cause of elderly patients is small intestinal ulcer/erosive(20.00%).The main causes of middle-aged and young patients in Beijing are small bowel angioectasias(66.67%in the elderly,44.44%in the middle age,and 43.75%in the youth).In the correlation analysis,there was no correlation between the presence of active intestinal bleeding and long-term use of anticoagulant/antiplate drugs(P>0.05).There was no correlation between the presence of small bowel ulcers and long-term use of aspirin(P>0.05).There is a correlation between valvular heart disease and small bowel angioectasias,and the risk is 10.623 times of non-heart valve diseases patients.In terms of diagnosis,the capsule endoscopy diagnosis rate was 65.3%,the small bowel enteroscopy diagnosis rate was 74.5%,and the CT diagnosis rate was 23.6%.There was no significant difference in the diagnostic rate between capsule endoscopy and small bowel enteroscopy(P>0.05).There was statistically different in the diagnostic rate between capsule endoscopy and CT(P<0.05).The diagnostic rate of capsule endoscopy for small bowel angioectasias was higher than that of CT,which was statistically different.There was no significant difference in the diagnostic rate of capsule endoscopy and CT for small intestinal tumors.Conclusion:The results of this study show that small bowel angioectasias is the primary cause of small intestinal bleeding,and the etiology-distribution of each age group are slightly different.There is a correlation between the region and the cause of the disease.The small bowel angioectasias is more common in the north,and the small intestine tumor or ulcer/smash is more common in the south.Capsule endoscopy and enteroscopy are better diagnostic methods.Capsule endoscopy is superior to CT in the small bowel angioectasias,but there is no difference in the diagnosis of small intestine tumor.Clinically,relevant examination methods should be selected according to different likely causes. |
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