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背景:小肠憩室是常见的消化道畸形,术前诊断困难。目前关于胶囊内镜对小肠憩室的诊断敏感性尚存在争议。目的:分析小肠憩室的临床特点,评价胶囊内镜对小肠憩室的诊断价值。方法:纳入2002年5月-2013年8月于上海交通大学医学院附属仁济医院行胶囊内镜检查并经手术或双气囊小肠镜确诊的小肠憩室患者,对患者一般情况、病变部位、临床表现、诊断情况、治疗方法和预后进行回顾性分析。结果:共33例患者纳入研究,其中男23例,女10例,平均年龄(41.4±21.9)岁,平均病程(41.4±39.3)个月。小肠憩室位于十二指肠3例,空肠6例,回肠24例。临床表现中消化道出血发生率为87.9%(29/33),腹痛、腹泻发生率为12.1%(4/33),贫血发生率为97.0%(32/33)。胶囊内镜对小肠憩室的诊断率为15.2%(5/33)。11例患者行手术治疗,22例患者接受对症处理。结论:胶囊内镜诊断小肠憩室不敏感,对于高度怀疑小肠憩室的患者,不应作为首选检查手段。
Background: Small bowel diverticulum is a common gastrointestinal malformation, preoperative diagnosis is difficult. Currently on the capsule endoscopic diverticulum sensitivity of the diagnosis is still controversial. Objective: To analyze the clinical features of small bowel diverticulum and to evaluate the value of capsule endoscopy in the diagnosis of small bowel diverticulum. Methods: The patients with small bowel diverticula diagnosed by capsule endoscopy and surgery or double balloon enteroscopy in Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine from May 2002 to August 2013 were enrolled in this study. The general condition, lesion site, clinical Performance, diagnosis, treatment and prognosis of the retrospective analysis. Results: A total of 33 patients were included in the study, including 23 males and 10 females with an average age of (41.4 ± 21.9) years and an average duration of (41.4 ± 39.3) months. Small intestine diverticulum is located in the duodenum in 3 cases, jejunum in 6 cases, ileum in 24 cases. Clinical manifestations of gastrointestinal bleeding was 87.9% (29/33), abdominal pain, diarrhea incidence was 12.1% (4/33), anemia was 97.0% (32/33). Capsule endoscopic diagnosis of intestinal diverticulum was 15.2% (5/33). Eleven patients underwent surgical treatment and 22 patients received symptomatic treatment. CONCLUSIONS: Capsule endoscopy is not sensitive to the diagnosis of small intestine diverticula and should not be considered as the first choice for patients with a highly suspected small bowel diverticulum.