Diagnosis and management of jejunoileal diverticular haemorrhage: An update on the experience in a single centre
Jejunoileal diverticular haemorrhage is a rare disease that is difficult to diagnose and treat. Despite advances in endoscopic technology, recommendations on diagnosis and management for jejunoileal diverticular haemorrhage have remained unchanged and these new options have not been compared against...
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description | Jejunoileal diverticular haemorrhage is a rare disease that is difficult to diagnose and treat. Despite advances in endoscopic technology, recommendations on diagnosis and management for jejunoileal diverticular haemorrhage have remained unchanged and these new options have not been compared against traditional surgical management. We retrospectively reviewed the diagnosis, management, and outcome for jejunoileal diverticular haemorrhage cases at our institution over the past 20 years. Data were organized and analysed by chi-square test, student t-test and Kaplan-Meier survival analysis. The most utilised diagnostic procedure was computed tomography, followed by enteroscopy, angiography, small bowel flow-through and surgery. Primary treatments included, in a decreasing order, medical therapy, surgery, endoscopy and radiology. Surgical treatment was not associated with rebleeding, but it did result in longer hospital stays and larger blood transfusions than non-surgical treatments. The bleeding-related mortality rate was very low. Notably, there was also little change in the diagnosis and treatment between decades. We presented our experience with the diagnosis and management of jejunoileal diverticular haemorrhage, as well as long-term follow-up after treatments that have not been reported previously. Surgical treatment continues to dominate management for jejunoileal diverticular haemorrhage, but we support increasing the role of endoscopy for select patient groups. |
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Despite advances in endoscopic technology, recommendations on diagnosis and management for jejunoileal diverticular haemorrhage have remained unchanged and these new options have not been compared against traditional surgical management. We retrospectively reviewed the diagnosis, management, and outcome for jejunoileal diverticular haemorrhage cases at our institution over the past 20 years. Data were organized and analysed by chi-square test, student t-test and Kaplan-Meier survival analysis. The most utilised diagnostic procedure was computed tomography, followed by enteroscopy, angiography, small bowel flow-through and surgery. Primary treatments included, in a decreasing order, medical therapy, surgery, endoscopy and radiology. Surgical treatment was not associated with rebleeding, but it did result in longer hospital stays and larger blood transfusions than non-surgical treatments. The bleeding-related mortality rate was very low. Notably, there was also little change in the diagnosis and treatment between decades. We presented our experience with the diagnosis and management of jejunoileal diverticular haemorrhage, as well as long-term follow-up after treatments that have not been reported previously. Surgical treatment continues to dominate management for jejunoileal diverticular haemorrhage, but we support increasing the role of endoscopy for select patient groups.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0234417</identifier><identifier>PMID: 32574171</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Angiography ; Biology and Life Sciences ; Bleeding ; Blood ; Blood transfusion ; Care and treatment ; Chi-square test ; Computed tomography ; Diagnosis ; Diagnostic systems ; Disease ; Endoscopy ; Gastrointestinal hemorrhage ; Health services ; Hemoglobin ; Hemorrhage ; Hemorrhagic shock ; Hospitals ; Management ; Medical diagnosis ; Medical imaging ; Medical records ; Medicine and Health Sciences ; Mortality ; Radiology ; Rare diseases ; Research and Analysis Methods ; Small intestine ; Statistical tests ; Studies ; Surgery ; Surgical equipment</subject><ispartof>PloS one, 2020-06, Vol.15 (6), p.e0234417-e0234417</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Su et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Despite advances in endoscopic technology, recommendations on diagnosis and management for jejunoileal diverticular haemorrhage have remained unchanged and these new options have not been compared against traditional surgical management. We retrospectively reviewed the diagnosis, management, and outcome for jejunoileal diverticular haemorrhage cases at our institution over the past 20 years. Data were organized and analysed by chi-square test, student t-test and Kaplan-Meier survival analysis. The most utilised diagnostic procedure was computed tomography, followed by enteroscopy, angiography, small bowel flow-through and surgery. Primary treatments included, in a decreasing order, medical therapy, surgery, endoscopy and radiology. Surgical treatment was not associated with rebleeding, but it did result in longer hospital stays and larger blood transfusions than non-surgical treatments. The bleeding-related mortality rate was very low. Notably, there was also little change in the diagnosis and treatment between decades. We presented our experience with the diagnosis and management of jejunoileal diverticular haemorrhage, as well as long-term follow-up after treatments that have not been reported previously. Surgical treatment continues to dominate management for jejunoileal diverticular haemorrhage, but we support increasing the role of endoscopy for select patient groups.</description><subject>Angiography</subject><subject>Biology and Life Sciences</subject><subject>Bleeding</subject><subject>Blood</subject><subject>Blood transfusion</subject><subject>Care and treatment</subject><subject>Chi-square test</subject><subject>Computed tomography</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Disease</subject><subject>Endoscopy</subject><subject>Gastrointestinal hemorrhage</subject><subject>Health services</subject><subject>Hemoglobin</subject><subject>Hemorrhage</subject><subject>Hemorrhagic shock</subject><subject>Hospitals</subject><subject>Management</subject><subject>Medical diagnosis</subject><subject>Medical imaging</subject><subject>Medical records</subject><subject>Medicine and Health 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treat. Despite advances in endoscopic technology, recommendations on diagnosis and management for jejunoileal diverticular haemorrhage have remained unchanged and these new options have not been compared against traditional surgical management. We retrospectively reviewed the diagnosis, management, and outcome for jejunoileal diverticular haemorrhage cases at our institution over the past 20 years. Data were organized and analysed by chi-square test, student t-test and Kaplan-Meier survival analysis. The most utilised diagnostic procedure was computed tomography, followed by enteroscopy, angiography, small bowel flow-through and surgery. Primary treatments included, in a decreasing order, medical therapy, surgery, endoscopy and radiology. Surgical treatment was not associated with rebleeding, but it did result in longer hospital stays and larger blood transfusions than non-surgical treatments. The bleeding-related mortality rate was very low. Notably, there was also little change in the diagnosis and treatment between decades. We presented our experience with the diagnosis and management of jejunoileal diverticular haemorrhage, as well as long-term follow-up after treatments that have not been reported previously. Surgical treatment continues to dominate management for jejunoileal diverticular haemorrhage, but we support increasing the role of endoscopy for select patient groups.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32574171</pmid><doi>10.1371/journal.pone.0234417</doi><tpages>e0234417</tpages><orcidid>https://orcid.org/0000-0002-3494-2245</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Angiography Biology and Life Sciences Bleeding Blood Blood transfusion Care and treatment Chi-square test Computed tomography Diagnosis Diagnostic systems Disease Endoscopy Gastrointestinal hemorrhage Health services Hemoglobin Hemorrhage Hemorrhagic shock Hospitals Management Medical diagnosis Medical imaging Medical records Medicine and Health Sciences Mortality Radiology Rare diseases Research and Analysis Methods Small intestine Statistical tests Studies Surgery Surgical equipment |
title | Diagnosis and management of jejunoileal diverticular haemorrhage: An update on the experience in a single centre |
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