Application Of Treatment And Diagnosis For Obscure Gastrointestinal Bleeding In Children

Objective :To evaluate the value of gastrocolonoscopy combine with laparoscopy which called “one-stop hybird operation ”mode.Quantifying the related indexes of digestive tract bleeding,summarizing and establishing the scoring system for obscure gastrointestinal bleeding of children.Methods:The clinical detail data of pediatric patients with digestive tract hemorrhage were collected,analysed and studied retrospectively in the department of pediatrics in Department of general surgery,Wuhan children's Hospital from January 1,2012 to December 31,2016.According to sex,age,pathological results,anemia,treatment,recurrence,and so on.The counting data were described statistically by percentage.The age was added or subtracted from the standard deviation by the mean(x ±s).Result:1.A total of 6710 cases of pediatric gastrointestinal hemorrhage were collected,including 118 cases of obscure gastrointestinal bleeding.There were 97 males and 21 females,and the male and female ratio was about 4.6:1.The age was 4.65 ±3.78 years old,ranging from one month and 16 days to 13 years and two monthes.Among them,56 cases were younger than3 years old(47.46%),27 cases were above 3 to 7years old(22.88%),21 cases were among 7 to 10 years old(17.80%),there are 14 cases were over 10 years old(11.86%).2.There were 79 cases confirmed by gastrocolonoscopy combine with laparoscopy “one-stop hybird operation ”mode,43 cases by ECT combined with laparoscopy mode,there are 10 cases treated by laparoscope combined with double balloon enteroscope.Another 14 cases were diagnosed by open operation.There was no statistical difference of the diagnostic rate between the gastrocolonoscopy combine with laparoscopy“one-stop hybird operation ”mode group and the groupwhich was treated by ECT combined laparoscopy mode.3.The level of anemia,bleeding color,bleeding frequency,blood transfusion and meaningful imaging examination were quantified,and the scoring system was established(as in appendix),and it was concluded that surgical intervention could be carried out as early as possible if the score reached 12 points.Conclusion:1.The mean age of children with obscure gastrointestinal bleeding is 4.5 years old,about 50% is within3 yearsold.The morbidity of male children was more than that of female,and what was finally found of the cause was mostly caused by Meckel's diverticulum.2.Gastrocolonoscopy combine with laparoscopy the“one-stop hybird operation ”mode can improve the diagnosis rate of children with obscure gastrointestinal bleeding and provide a new idea for treatment,which is worth popularizing in hospital.3.According to the established scoring system for children,if the score is more than 12,we think it is necessary to carry out surgical intervention as soon as possible and find out the etiology.Quantifying each index to establish the corresponding scoring system can relax the indication of surgical intervention.Further multi-center prospective studies are needed.