Open AccessCauses and Clinical Characteristics of Small Bowel Bleeding in Northern Vietnam
Author(s) -
Cong Long Nguyen,
Khac Khiem Pham,
Canh Hiep Nguyen,
Hoang Nam Nguyen,
Tran Tien Dao,
Hoài Nam Nguyễn,
Van Tuyen Pham,
Tuan Thanh Nguyen,
AnhTuan Vu,
Truong Khanh Vu
Publication year - 2020
Publication title -
canadian journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.921
H-Index - 65
eISSN - 2291-2797
pISSN - 2291-2789
DOI - 10.1155/2020/8884092
Subject(s) - medicine , melena , hematochezia , enteroscopy , incidence (geometry) , angiodysplasia , double balloon enteroscopy , population , gastroenterology , surgery , colonoscopy , endoscopy , colorectal cancer , cancer , physics , environmental health , optics
Aim Causes, clinical features, and diagnostic approaches for small bowel (SB) bleeding were analyzed to derive recommendations in dealing with this clinical condition.Methods We included 54 patients undergoing surgical treatment for SB bleeding, from January 2009 to December 2019. Detailed clinical data, diagnosis procedures, and causes of bleeding were collected.Results Among 54 cases with SB bleeding, the most common causes were tumors (64.8%), followed by angiopathy (14.8%), ulcers (9.3%), diverticula (5.6%), tuberculosis (3.7%), and enteritis (1.9%). Most tumors (32/35 cases, 91.4%) and vascular lesions (8/8 cases, 100%) were located in the jejunum. The incidence of tumors was higher in the older (30/41 cases, 73.1%) than that in patients younger than 40 years of age (5/13 cases, 38.5%, P < 0.01). Common initial findings were melena (68.5%) and hematochezia (31.5%). The overall diagnostic yield of computed tomographic enterography (CTE) was 57.4% (31/54 cases), with the figures for tumors, vascular lesions, and inflammatory lesions being 71.4% (25/35 cases), 62.5% (5/8 cases), and 12.5% (1/8 cases), respectively. Double-balloon enteroscopy (DBE) definitively identified SB bleeding sources in 16/22 (72.7%) patients.Conclusion Tumors, angiopathy, ulcers, and diverticula were the most common causes of SB bleeding in Northern Vietnamese population. CTE has a high detection rate for tumors in patients with SB bleeding. CTE as a triage tool may identify patients before double-balloon enteroscopy because of the high prevalence of SB tumors.