Ruột non là một nguồn quan trọng của bệnh lý, đặc biệt là xuất huyết tiêu hóa mạn tính và kém hấp thu. Nó có thể là cần thiết để truy cập vào ruột non nơi jejunostomies. Ngoài ra, ở những bệnh nhân tình trạng bài Roux en Y gastrojejunostomy, | 124 Gastrointestinal Endoscopy Summary The small intestine is an important source of pathology particularly in chronic gastrointestinal bleeding and malabsorption. It may be necessary to access the small intestine to place jejunostomies. In addition in patients who are status post Roux en Y gastrojejunostomy push enteroscopy may permit manipulation of the pancreatic and biliary tree. Screening for small intestinal polyps and the polyposis syndromes can be effectively carried out with push enteroscopy. Sonde enteroscopy may be useful in evaluating the small intestine in patients with chronic gastrointestinal bleeding. However its limitations may outweigh its usefulness. In our opinion intraoperative enteroscopy is the procedure of choice in patients with transfusiondependent chronic occult gastrointestinal bleeding of presumed small intestinal etiology. We believe that a Sonde enteroscope is less traumatic than a standard colonoscope or push enteroscope. It will permit evaluation of the small intestine with a decrease in the complication rate. Cooperation between the surgeon and the endoscopist is essential. In carefully selected patients we believe this to be an excellent modality in the diagnosis and management of chronic gastrointestinal bleeding. Selected References 1. Waye JD. Enteroscopy. Gastrointest Endosc 1997 46 247-256. This is an excellent review of all three types of enteroscopy. The data is carefully reviewed. There is an excellent discussion by that author. 2. Rutgeerts T Wilmer A. Push enteroscopy Technique depth and yield of insertion. In Barkin J ed. Gastrointest Endosc Clinics North Am 1996 759-776. This is a thorough and excellent review of the technique of push enteroscopy. 3. Lewis B. Small intestinal bleeding. In Gastroenter Clinics North Am 1994 67. This is an excellent overview of evaluation and management of small intestinal bleeding in general. Different diagnostic and therapeutic options are discussed. In addition the different etiologies
