Enteroscopic manifestations of intestinal infiltration affected by leukemic cells from patients with acute lower digestive tract bleeding as the first manifestation

Abstract

Objective To summarize enteroscopic characteristics of intestinal infiltration affected by leukemic cells with acute lower digestive tract bleeding (DTB) as first manifestation.Methods 3 224 firstvisit and hospitalized leukemia patients from May,2000 to October,2010 were retrospected and evaluated.Among them,there were 59 patients with a complaint of DTB as the first manifestation,and they were immediately examined by gastro/enteros copic apparatus after hospitalization,followed by analysis of histopathologic results,molecular biology and cytogenetics and clinical data.They were divided into two groups according to bleeding rate and bleeding volume.Results There were 59 leukemia cases of DTB as an initial symptom with the incidence rate of 1.83 ％ (59/3 224).Among them,there were 19 cases for acute DTB (acute bleeding group),consisting of 13 cases (0.40 ％) of acute lower DTB (12 cases for acute leukemia,1 for lymphoma),and 6 patients (0.19 ％) for acute upper DTB (all for acute myelocytic leukemia).There were 40patients (0.59 ％) for chronic DTB (chronic bleeding group).The number of acute leukemia patients (76.27 ％,45/59) was significantly higher than that of chronic leukemia patients (23.73 ％,14/59) among the first-visit leukemia patients with DTB as an initial symptom (x2 =8.72,P ＜ 0.01).In acute leukemia patients,acute promyelocytic leukemia occupied 73.33 ％ (33/45).Conclusions Leukemia patients with DTB as the first manifestation are not rare,and the incidence rate of DTB from acute leukemia is higher than that from chronic leukemia.The enteroscopic features of intestinal infiltration affected by leukemic cells from patients with acute lower DTB as the first manifestation show that intestinal infiltrations involved wide-range and big volume bleeding,and present polymorphous with much diversity.But in chronic bleeding group,it is shown that infiltrations involved small-range,which might be related to clotting mechanism,platelet function and count. Key words: Digestive tract bleeding; Leukemia; Enteroscopes; Leukemic infiltration