| Objective: This study aimed to investigate the etiology and surgical treatment of small intestinal bleeding(SIB),summarize the etiology and surgical methods,provide ideas for the accurate diagnosis and treatment of small intestinal bleeding(SIB).Methods:A retrospective study was performed on 69 small intestinal bleeding(SIB)cases admitted to the Gastroenterology,Gastrointestinal surgery and Emergency Surgery Department of The first affiliated hospital of Xinjiang Medical University from March 2014 to March 2019,made a summary and comparison on the etiology and surgical treatment of these patients.Results:Diverticulum accounted for31.88%of the69 SIB patients followed by tumor(24.64%),inflammatory lesions(17.39%),vascular diseases(14.49%),ischemic diseases(5.80%),intuscale(4.35%),and Boy-Yeager syndrome(1.45%)..The most common sites of bleeding were ileum(53.63%),jejunum(33.33%),and jejunum + ileum(13.04%).The most common histopathological type in tumor patients was stromal tumor(15.94%),followed by adenocarcinoma(5.80%),neuroendocrine tumor(1.45%),and leiomyoma(1.45%).The most common bleeding form of SIB was chronic overt bleeding(50.72%),followed by chronic recessive bleeding(34.78%),and acute massive bleeding(14.49%).Among the61 patients undergoing surgical treatment,69.57% underwent exploratory laparotomy and 18.84%underwent laparoscopic surgery.The main surgical methods included partial small-bowel resection(88.52%),diverticulum varus suturing(6.56%)and intussusception reduction(4.92%).The good rates of exploratory laparotomy was 91.67% while the good rate of laparoscopic surgery was 92.31%.Meanwhile,the incidence of complications was the same between the laparoscopic surgery and laparoscopic surgery,and there was no statistically significant difference between the good rates and the incidence of complications(P > 0.05).The indicators including surgery duration,intraoperative bleeding,postoperative pain score(VAS score),postoperative feeding time,and length of stay were all superior to laparotomy,with statistically significant differences(P < 0.05).Conclusion: Diverticulum,tumor and inflammation are the main causes of SIB,and the main causes of different age groups are also different.The clinical manifestations of SIB are lack specificity.In general,chronic overt bleeding and chronic recessive bleeding are more common,and elective surgery is the first choice for those two forms of bleeding.As for acute massive apparent bleeding,it`s the first choice of emergency surgery and exploratory laparotomy is preferred in emergency surgery..Laparoscopic surgery is safer and more effective than exploratory laparotomy.If the patient’s condition,medical condition and surgeon’s technique permit,laparoscopic surgery can be the better choice for the SIB patient. |
