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严重下消化道出血(Sever lower intestinal hemorrhage,简称SLIH)是指屈氏韧带以下消化道大量出血,伴有明显低血容量的临床表现或休克而急需输液输血者。由于SLIH的病情紧急,死亡率较高,病因繁多,临床特征少,下消化道范围广难以明确具体出血部位等问题,常给诊断与处理带来许多困难,有必要复习和探讨。 一、病因 病因繁多,出血部位广泛。据Wirsching总结132例SLIH的病例中57.5％的出血部位在直肠,30.3％在结肠,10.6％在小肠,未发现病变者占1.6％。出血病因:直肠癌与息肉占31.1％,痔25％。直肠溃疡9.1％,多发憩室7.6％,肠道感染
Severe lower intestinal hemorrhage (Sever lower intestinal hemorrhage, referred to as SLIH) refers to a large number of bleeding below the Qiu’s ligaments gastrointestinal bleeding, with significant clinical manifestations of hypovolemia or shock and the need for transfusion transfusion. Because SLIH is in an emergency condition with high mortality rate, many causes, few clinical features, and a wide range of lower gastrointestinal tract, it is difficult to identify specific bleeding sites. This often brings many difficulties in diagnosis and treatment, and it is necessary to review and discuss SLIH. First, the cause of many causes, bleeding a wide range. According to Wirsching, 57.5% of the 132 SLIH cases had rectal bleeding, 30.3% were in the colon, and 10.6% were in the small intestine. No lesions were found in 1.6% of the patients. Causes of bleeding: Rectal cancer and polyps accounted for 31.1%, hemorrhoids 25%. Rectal ulcer 9.1%, multiple diverticulum 7.6%, intestinal infection