ABSTRACT
At present, coronavirus disease 2019 (COVID-19) caused by 2019 novel coronavirus (2019-nCoV) infection has spread rapidly in China and more than 70 countries around the world and thus become a public health event of international concern. In addition to fever and respiratory symptoms, varying degrees of liver injury is also observed after 2019-nCoV infection. This article reviews the clinical features, pathology, pathogenic mechanism, and therapeutic strategies of liver injury associated with COVID-19, hoping to provide a reference for clinical decision-making on the prevention and treatment of COVID-19.
ABSTRACT
Background:Small intestinal bleeding is difficult to diagnose and treat because of its complex etiology and limit to examination method. Aims:To analyze the etiology,diagnosis,treatment and prognosis of small intestinal bleeding. Methods:The clinical data of 118 consecutive patients with small intestinal bleeding admitted from Oct. 2006 to Oct. 2016 at Daping Hospital,the Third Military Medical University were retrospectively analyzed. Results:Melena was the most common manifestation of small intestinal bleeding (41. 5％),followed by dark bloody stool,positive fecal occult blood test,hematochezia,and anemia with unknown cause. The major causes of bleeding were benign or malignant tumors (43. 2％),vascular lesions (28. 0％)and inflammatory lesions (15. 3％). Diagnosis was made by means of capsule endoscopy,colonoscopy,digital subtraction angiography (DSA),barium meal examination,multi-slice CT (MSCT)and CT enterography (CTE). Forty-one patients were treated by surgical operation,7 by selective arterial embolization,2 by endoscopic therapy,56 by conservative therapy,and all these patients achieved hemostasis. One patient died of massive hemorrhage and 11 were discharged with giving up of treatment. Conclusions:The leading cause of small intestinal bleeding is tumor,followed by vascular and inflammatory lesions. Capsule endoscopy is able to make definite diagnosis with high accuracy,and MSCT is the most widely used diagnostic approach. In addition to conventional treatment,surgical operation,interventional and endoscopic therapies also play important roles in treating small intestinal bleeding.