PMID- 16737419
OWN - NLM
STAT- MEDLINE
DCOM- 20060705
LR  - 20190917
IS  - 1130-0108 (Print)
IS  - 1130-0108 (Linking)
VI  - 98
IP  - 3
DP  - 2006 Mar
TI  - Acute lower gastrointestinal hemorrhage originating in the small intestine.
PG  - 196-203
AB  - INTRODUCTION: Lower gastrointestinal hemorrhage (LGIH) is generally 
      self-limiting, and the most frequent etiologies are located at colonic level. The 
      objective here is to analyze the diagnostic and therapeutic handling of acute 
      LGIH when its etiology was located in the small intestine. PATIENTS AND METHODS: 
      Between 1975 and March 2002, 12 acute cases of LGIH originating in the small 
      intestine were admitted to our service. All consulted the hospital with acute 
      rectorrhage, requiring a transfusion of at least 3 units of concentrated red 
      blood cells. The mean age was 54 +/- 21 years, 58% were women, and 83% had 
      experienced previous episodes of LGIH. RESULTS: in eleven cases (92%) an urgent 
      lower and upper endoscopy was performed without locating the source of bleeding. 
      An arteriography was indicated in 7 patients (58%), which located the bleeding 
      origin in 5 of them. In two cases a scintigraphy was performed, showing a 
      Meckel's diverticulum in one patient and a normal image in another. All were 
      operated on; in 8 cases (67%), surgery was urgent; in 9 cases, a tumor was found, 
      and in three additional patients, a case of Meckel's diverticulum was found, with 
      a resection being carried out for all lesions. Histology showed a leiomyoma in 7 
      cases, a Meckel's diverticulum in 3 cases, a leiomyoblastoma in 1, and an angioma 
      in the remaining case. After a mean follow-up of 132 +/- 75 months, the 
      leiomyoblastoma resulted in death, and there was a relapse in the case of 
      angioma, which was successfully embolized with interventional radiology. 
      CONCLUSIONS: Acute LGIH originating in the small intestine should be considered a 
      possible etiology when digestive endoscopy does not locate the source of 
      bleeding, with arteriography being a useful diagnostic technique for bleeding 
      localization. Surgery is the definitive treatment--it confirms the etiology and 
      rules out the presence of malignancy.
FAU - Rios, A
AU  - Rios A
AD  - Department of Surgery, Hospital Universitario Virgen de la Arrixaca, El Palmar, 
      Murcia, Spain. ARZRIOS@teleline.es
FAU - Montoya, M J
AU  - Montoya MJ
FAU - Rodriguez, J M
AU  - Rodriguez JM
FAU - Parrilla, P
AU  - Parrilla P
LA  - eng
LA  - spa
PT  - Journal Article
PL  - Spain
TA  - Rev Esp Enferm Dig
JT  - Revista espanola de enfermedades digestivas
JID - 9007566
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - *Gastrointestinal Hemorrhage/diagnosis/etiology/surgery
MH  - Humans
MH  - Intestinal Diseases/complications
MH  - *Intestine, Small
MH  - Male
MH  - Middle Aged
EDAT- 2006/06/02 09:00
MHDA- 2006/07/06 09:00
CRDT- 2006/06/02 09:00
PHST- 2006/06/02 09:00 [pubmed]
PHST- 2006/07/06 09:00 [medline]
PHST- 2006/06/02 09:00 [entrez]
AID - 10.4321/s1130-01082006000300006 [doi]
PST - ppublish
SO  - Rev Esp Enferm Dig. 2006 Mar;98(3):196-203. doi: 10.4321/s1130-01082006000300006.