Application of laparoscopy combined with emission computed tomography in diagnosis and therapy of small intestine hemorrhage in children

Abstract

Objective To explore the clinical application value of two-port laparoscopy combined with emission computed tomography (FCT) in diagnosis and therapy of pediatric small intestine hemorrhage.Methods 167 children associated with gastrointestinal hemorrhage were admitted in our center from January 2004 to December 2009.99mTc-pertechnetate abdominal scintigraphy was performed in 72 patients with a history of recurrent hemafecia or melena,and they were targeted for present study.All the 72 patients underwent laparoscopic exploration.Results Among the 72 patients,59 patients showed positive results in scintigraphy.They were further confirmed by laparoscopic surgery and pathological examinations,including Meckel's diverticulum in 47 and duplications of alimentary tract in 9,and angioma in 3.Remain 13 patients with negative scintigraphy were shown Meckel's diverticulum in 7,duplications of alimentary tract in 2,blue rubber bleb nerus syndrome in 1,and anaphylactoid purpura in 2 via laparoscopic surgery and pathogenic examination,and no organic pathologic changes was identified by laparoscopy in 1 patient.All of them recoverd after therapy.No further bleeding was seen in follow-up.Conclusions ECT is an important candidate in diagnosis of small intestine hemorrhage in children.The combination of laparoscopy and radionuclide imaging not only brings benefit to diagnosis and treatment in such patients,but also effectively reduce the damage by conventional open exploratory laparotomy. Key words: Gastrointestinal hemorrhage; Laparoscopy