The Analysis Of 80 Cases Of Small Intestinal Disease

Objective: Because of the specific anatomical characteristics and lack of characteristic symptoms of small intestine,small intestinal diseases have been the difficulty of examination.80 cases diagnosed of small intestinal disease from Second Hospital of Tianjin Medical University in recent 6 years were studied retrospectively,and their major symptoms,etiology and diagnostic methods were analyzed,to explore the clinical features of small intestinal diseases and the application efficiency of three main diagnostic methods in our hospital,so as to improve the understanding of small intestinal disease and improve the diagnostic rate.Methods:80 cases of small intestinal disease from our hospital between 2009.11 to 2016.3 diagnosed by clinical diagnosis(including symptoms,signs and laboratory examination),imaging diagnosis,(including CE,gastrointestinal radiography and MSCTE),surgical biopsy and were enrolled.Analysis of their clinical manifestations,diagnoses and diagnostic methods were conducted.The total detection rate and diagnostic accuracy by three major diagnostic methods were compared.According to the different indications of small bowel examination,the detection rate and diagnostic value of three kinds of small bowel examination in our hospital were analyzed.Result: 1.42 cases were male and 38 cases were female of the 80 cases diagnosed of small intestinal diseases.Male to female ratio was 1.11:1.The clinical manifestations showed abdominal pain in 54 cases(67.5%),abdominal mass in 42 cases(52.5%),anemia in 25 cases(31.25%),gastrointestinal bleeding in 35 cases(43.75%),weight loss in 33 cases(41.25%),abdominal distention in 11 cases(13.75%),diarrhea in 8 cases(10%),loss of appetite in 17 cases(21.25%),fever in 7 cases(8.75%).2.In 80 patients with small intestinal diseases,40 cases with tumors accounted for the majority(50%),including of 17 cases with adenocarcinoma,16 cases with stromal tumors,7 cases with lymphoma,in which adenocarcinoma and stromal tumors accounted for the majority.Other 10 cases(20%)with vascular malformations.16 cases with inflammatory diseases,including 5 cases with Crohn’s disease,11 caseswith nonspecific inflammation.In addition,there were 8 cases with polyps,14 cases with diverticulum.3.The detection rate of MSCTE was the highest in total detection for small intestinal disease in our hospital,followed by CE,and gastrointestinal barium radiography was the lowest.The difference was statistically significant(P<0.05).In the diagnostic accuracy,the gastrointestinal barium radiography was also the lowest.No difference was found in the diagnostic accuracy of CE and MSCTE(P>0.05).4.35 cases with OGIB including of 9 cases with chronic nonspecific inflammation,3 cases with Crohn’s disease,10 cases with vascular malformations,4 cases with adenocarcinoma,1 case with lymphoma,3 cases with stromal tumors,5 cases with diverticulum.The inflammation was the most,followed by vascular lesions,and tumor was the least.For patients with OGIB,the detection rate of CE was higher than MSCTE,much higher than gastrointestinal barium radiography(P<0.05).5.54 cases with UAP including of 21 cases with tumor(11 cases with adenocarcinoma,8 cases with stromal tumors,2 cases with lymphoma..For patients with UAP,the detection rate of gastrointestinal barium radiography was the lowest,and no difference was found between CE and MSCTE.Conclusion:The clinical manifestations of small intestinal diseases are lack of specificity,and most of the pathogeny are inflammatory diseases and tumors.When symptoms as abdominal pain,diarrhea,abdominal mass,gastrointestinal bleeding and other symptoms appear,and difficult to explain after excluding the stomach and colon disease using gastroscopy and colonoscopy,it is time to consider the small bowel disease.Both of the detection rate and diagnostic accuracy of CE and MSCTE are higher than the gastrointestinal barium radiography.For patients with OGIB,CE should be as the first choice.With the rapid development of various inspection techniques,the diagnosis of small bowel diseases will be more perfect,and the detection rate will be higher and higher.