双气囊电子小肠镜诊断67例不明原因腹痛的价值

目的 评价双气囊电子小肠镜对不明原因慢性腹痛的诊断价值,探讨小肠病变所致腹痛病因.方法 对2005年6月至2008年6月中南大学湘雅医院67例有慢性腹痛症状,经胃镜、结肠镜、全消化道钡餐、腹部B超及心电图检查阴性的患者行双气囊电子小肠镜检查.结果 67例患者中,36例经肛进镜,19例经口进镜,12例患者接受2次检查分别经口和经肛进镜.41例发现病灶,阳性检出率为61.19%.41例病变包括克罗恩病15例(36.59%),非特异性小肠炎10例(24.39%),肿瘤8例(19.51%),其他病变8例(19.51%).结论 双气囊电子小肠镜对小肠病变所致慢性腹痛具有较高临床诊断价值.小肠克罗恩病、非特异性小肠炎及小肠肿瘤为不明原因小肠源性腹痛最常见病因.

The diagnostic value of double-balloon enteroscopy in 67 cases with obscure abdominal pain

Objective To evaluate the diagnostic valve of double balloon enteroscopy in patients with obscure abdominal pain and analyze the etiology of chronic abdominal pain resulted from enteral diseases. Methods Sixty-seven cases with chronic abdominal pain underwent a previous negative gastroscopy, colonoscopy, gastrointestinal barium, B ultrasound and electrocardiogram were received double balloon enteroscopy during June 2005 to June 2008. Results Thirty-six of 67 patients was done by enteroscopy via anus, and 19 cases via oral, and 12 cases via both anus and oral. The lesions were found in 41 of the 67 patients, with overall diagnostic yield of 61.19%. Among 41 cases of abdominal pain resulted from small bowel diseases, Crohn's disease were found in 15 cases (36.59%), non-specific small enteritis in 10 cases (24.39%), tumors in 8 cases (19.51%),other enteral diseases in 8 cases (19.51%). Conclusions Double balloon enteroscopy was a diagnostic modality with a high diagnostic value for obscure abdominal pain resulted from small bowel diseases. The most common causes of obscure abdominal pain were Crohn's disease, non-specific small enteritis and tumors.