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Open Access Research article

Analysis of the causes and clinical characteristics of jejunoileal hemorrhage in China: a multicenter 10 year retrospective survey

Da-lei Jiang18, Hui-ya Liu19, Yong Yuan2, Jian-chao Sui3, Chang-chun Jing4, Kai-tong Jiang5, Qing-cai Wang6, Sheng-an Yuan7, Hai-ying Chen1 and Yan-jing Gao1*

Author Affiliations

1 Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China

2 The Medical Department The Affiliated Hospital of Medical College, Qingdao University, Qingdao, China

3 Department of Gastroenterology, Wen-Deng People's Hospital, Wen-Deng, China

4 Department of Gastroenterology, Liao-cheng Second People's Hospital, Liao-cheng, China

5 Department of Gastroenterology, Lin-Yi People's Hospital, Lin-Yi, China

6 Department of Gastroenterology, Tai-An People Hospital, Tai-An, China

7 Department of Gastroenterology, Zi-bo People's Hospital, Zi-bo, China

8 Department of Gastroenterology, Qing-Dao Municipal Hospital, Qing-Dao, China

9 Department of Gastroenterology, He-Ze Municipal Hospital, He-Ze, China

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BMC Gastroenterology 2012, 12:101  doi:10.1186/1471-230X-12-101

Published: 6 August 2012

Abstract

Background

A retrospective study was performed to assess the causes, diagnostic methods for, and clinical features of, jejunoileal hemorrhage in Shandong province, China and to derive recommendations for management of this condition from these data.

Methods

We performed a retrospective systematic collection of data from between January 1999 and December 2008 in seven cities in Shandong province, China, identified 72 patients with jejunoileal hemorrhage and analyzed the relevant clinical data.

Results

Overall, tumors were the most common cause of jejunoileal hemorrhage (42 patients, 58.3%). The causes of this condition were significantly different (P < 0.05) in male and female patients. In male patients, the commonest factors were tumor (52.2%), enteritis (17.4%) and angiopathy (15.2%). However, in female patients, tumors accounted for a greater proportion of cases (18/26, 69.2%). In 38 cases (52.8%) the diagnosis was made by intraoperative enteroscopy or laparotomy, in 14 by capsule endoscopy and in the remainder by radiological methods. The most frequent presentation was melena (62.7%), followed by maroon stools (26.9%) and hematochezia (9.0%). Of the 72 patients,laparotomy is the main treatment method.

Conclusion

Tumor, enteritis and angiopathy and diverticular disease are the most common causes of jejunoileal hemorrhage in Shandong province, China. The main clinical manifestations are bloody stools, most commonly in the form of melena, with or without abdominal pain. We recommend that female patients over the age of 40 with jejunoileal hemorrhage accompanied by abdominal pain should undergo urgent further assessment because of the strong probability of jejunoileal tumor.

Keywords:
Cause; Clinical features; Diagnosis; Jejunoileal hemorrhage