Middle gastrointestinal bleeding. 7 years later

Authors

  • Jorge Landaeta Policlínica Metropolitana. Caracas,
  • Carla Dias Clínica Santiago de León. Caracas,
  • Virginia Armas GastroExpress. Caracas,
  • Ornella Tempestini Policlínica Metropolitana. Caracas,
  • Crizelys Bolívar Policlínica Metropolitana. Caracas,

Keywords:

Middle digestive hemorrhage (MDH), small intestine (SB), single balloon enteroscopy (SBE), double balloon enteroscopy (DBE).

Abstract

Introduction: Approximately in 5% of patients with bleeding, the origin is not found in videogastroduodenoscopy or colonoscopy. Of these, 75% have their origin in the small intestine. Long-term follow-up has not been evaluated in our country. Objective: To evaluate rebleeding in patients with middle digestive hemorrhage. Materials and methods: Retrospective study, 136 EAB (111 patients), March 2001-September 2010 with potential mean digestive hemorrhage (PMDH). Results: 111 patients with: anemia 76 (68.4%), melena 13 (11.7%), hematochezia 11 (9.9%), rectorraghia 6 (5.4%), active bleeding 1 (1%), shock 4 (3.6%). 28 patients reported comorbid. Findings: angiodysplasia 40 (31%), lymphagiectasias (5), subepithelial Tu (5), Dieulafoy lesion (4), Crohn's disease (4), ulcers (4), active bleeding (3), angiomas (3). Endoscopic hemostasis was performed in 61 patients (59 patients with success). One with active bleeding, previous tattoo was referred to surgery and the other (lymphangioma) was performed new endoscopic therapy with clips. Of the 111 patients, 23 re-bleeding (20.7%), (74% had comorbid). Of these, 17 patients had received endoscopic treatment. New endoscopic therapy was performed in all (23 patients). During a 7-year follow-up, 5 patients had a second episode of rebleeding at 3.8 years (3-5 years) and were resolved endoscopically. Conclusions: After successful primary endoscopic haemostasis, rebleeding episodes occur in 20.7% of patients with a 7-year follow-up. The recurrence rates of bleeding were higher in patients with vascular lesions and enteroscopies that showed normal mucosa. In both, comorbidity is a risk factor for rebleeding. The long-term management of MDH due to vascular lesions of the small intestine remains a challenge.

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How to Cite

Landaeta, J., Dias, C., Armas, V., Tempestini, O., & Bolívar, C. (2018). Middle gastrointestinal bleeding. 7 years later. Revista GEN, 72(3), 70–76. Retrieved from http://saber.ucv.ve/ojs/index.php/rev_gen/article/view/15923

Issue

Vol. 72 No. 3 (2018)

Section

ORIGINAL ARTICLE

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