A case of civil pilot with small intestine diverticulosis complicated by ulcer bleeding and literature review

Abstract

Objective To explore the diagnosis,treatment and medical assessment of the pilot suffering from small intestine diverticulosis,and provide the reference to aeromedical assessment of military and civil pilots and physical examination of pilot recruitment.Methods A case of civil pilot suffering from small intestine diverticulosis with ulcer bleeding was analyzed.By referring to the literature review,the pathophysiologic features,clinical manifestations,diagnosis and treatments for intestine diverticulosis were summarized.Results The intestine diverticulosis with ulcer bleeding was diagnosed by the capsule endoscopy and double-balloon enteroscopy.With the treatments of hemostasis,anti-infection and the consolidation of dietary nutrition,the pilot was recovered and qualified for flying.18months follow up showed that he was in normal physical condition.Conclusion Pilots suffering from small intestine diverticulosis and obscure gastrointestinal bleeding can be diagnosed by capsule endoscopy and double balloon enteroscopy.If small intestine diverticulosis was in stable,it wouldn't affect flying and treatment wouldn't be required.If small intestine diverticulosis combined with ulcer bleeding and infection,the hemostatic and anti-infection treatments would be required.If small intestine diverticulosis was with ulcer bleeding and had been affected,treatment of hemostasis and anti-infective treatment should be taken.Military transporter pilot and civil pilot can be qualified for flying in case of blood loss stopped and fitness recovered.The surgery should be considered if conservative treatment failed,or recurrent diverticulosis complication appeared.The assessment should be individually issued according to pilot's postoperative recovery.Routine capsule endoscopy examination is recommended due to its effective diagnosis and reference value to the physical examination of pilot recruitment. Key words: Intestine, small; Diverticulum; Physical examination; Eligibility determination