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논문 기본 정보

자료유형
학술저널
저자정보
Jung Min Bae (Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea)
저널정보
대한외상중환자외과학회 Journal of Acute Care Surgery Journal of Acute Care Surgery Vol.14 No.2
발행연도
2024.7
수록면
41 - 44 (4page)
DOI
10.17479/jacs.2024.14.2.41

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초록· 키워드

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Small bowel bleeding (SBB) accounts for 5%-10% of all gastrointestinal bleeding (GIB) cases. Severaldiagnostic modalities in SBB are performed. However, the small bowel is beyond the reach of thesediagnostic modalities. A large amount of bleeding in GIB is a key factor leading to a poor prognosis. Appropriate and prompt diagnostic and treatment strategies are needed. Several diagnostic andmanagement algorithms have been proposed. However, the processing of algorithm is complex andfrequent mistakes are happened. Because of surgical aspects and sudden or gradual development ofhemodynamic instability in SBB, algorithms considering surgical role and treatment have been published. The intra-operative enteroscopy (IOE) is a gold-standard method for detecting lesions in SBB. Theprimary goal of IOE is to detect specific bleeding focus in SBB. The determining the resection range is thesecondary goal. In most cases in SBB, segmental resection is treatment of choice. However, in bleedingdistal duodenum from distal to the ampulla of Vater to Treitz ligament, pancreas preserving distalduodenectomy could be performed. In terminal ileum bleeding, after resection of pathologic bowel, thereconstruction option is ileo-colic anastomosis or end enterostomy. Because of frequently developed post-operative morbidity and mortality, post-operative critical care is perfectly fit for an acute care surgeon’srole. Therefore, in the entire management process, an interprofessional team or multidisciplinaryapproach is critical for improving the quality of care of SBB and decreasing mistakes.

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