scholarly journals Obscure gastrointestinal bleeding with negative abdominal computed tomography study: The importance of enteroscopy for early diagnosis of small bowel malignancy

JGH Open ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 94-96
Author(s):  
Meng‐Yu Ko ◽  
Chi‐En Yen ◽  
Hsu‐Heng Yen
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Early Diagnosis ◽  
Gastrointestinal Bleeding ◽  
Obscure Gastrointestinal Bleeding ◽  
Abdominal Computed Tomography ◽  
Small Bowel Malignancy

scholarly journals Factors Affecting Route Selection of Balloon-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1860
Author(s):  
Dong Hoon Baek ◽  
Seonyeong Hwang ◽  
Chang Soo Eun ◽  
Seong Ran Jeon ◽  
Jinsu Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Obscure Gastrointestinal Bleeding ◽  
Route Selection ◽  
Barium Study ◽  
Diagnostic Modality ◽  
Factors Affecting ◽  
Selection Of

Balloon-assisted enteroscopy (BAE) is an important diagnostic modality for ongoing obscure gastrointestinal bleeding (OGIB). However, it is difficult to determine the optimal insertion route. We retrospectively analyzed the records of patients with OGIB contained in a multicenter enteroscopy database of 1108 balloon-assisted enteroscopy (BAE) procedures (875 patients) to find out factors affecting BAE route selection in patients with OGIB. A total of 603 BAE procedures in 512 patients were investigated: there were 392 (65.0%) bidirectional and 211 (35.0%) unidirectional procedures. Overt OGIB was more frequent in the latter group (p = 0.024). Computed tomography (CT) was more frequently performed in the unidirectional group (p < 0.001). Capsule endoscopy and a small bowel barium study were performed more frequently in the bidirectional group (p < 0.001 and p = 0.039, respectively). Multivariate analysis showed that occult OGIB, capsule endoscopy and a small bowel barium study were independently associated with use of the bidirectional approach (p = 0.011, p = 0.013 and p = 0.046, respectively). Conversely, CT was associated with use of the unidirectional approach (p < 0.001). Conclusion: CT can aid the selection of an optimal insertion route in OGIB patients. However, capsule endoscopy and small bowel barium study are unhelpful.

scholarly journals Obscure Gastrointestinal Bleeding Caused by Small Bowel Lipoma

2008 ◽  
Vol 47 (18) ◽  
pp. 1601-1603 ◽  
Author(s):  
Jen-Wei Chou ◽  
Chun-Lung Feng ◽  
Hsueh-Chou Lai ◽  
Chin-Chi Tsai ◽  
Sheng-Hung Chen ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Obscure Gastrointestinal Bleeding

scholarly journals Massive obscure GI bleeding from Idiopathic Jejunal varices identified using single balloon enteroscopy

2019 ◽  
Vol 16 (1) ◽  
pp. 62-71
Author(s):  
Natasha Harris ◽  
Alaa Rostom ◽  
Husein Moloo
Keyword(s):  
Small Bowel ◽  
Literature Review ◽  
Gastrointestinal Bleeding ◽  
Surgical Resection ◽  
Obscure Gastrointestinal Bleeding ◽  
Gi Bleeding ◽  
Jejunal Varices ◽  
Single Balloon ◽  
Single Balloon Enteroscopy ◽  
Small Bowel Varices

Background:  Obscure gastrointestinal bleeding from idiopathic small bowel varices is both a diagnostic and management challenge for physicians. There are very few cases reported in the literature and there is no consensus on management recommendations. Aims:  To present the case of a 34-year-old male patient with bleeding from idiopathic jejunal varices and to review similar cases in the literature.  Methods:  A case of idiopathic jejunal varices is reported. A literature review was conducted and a total of 24 articles describing idiopathic small bowel varices were identified. Results:  Case Report: A 34-year-old gentleman was referred for worsening obscure gastrointestinal bleeding and anemia. Anterograde single balloon enteroscopy revealed several petechial like lesions that were not classic for angiodysplasia. These lesions were initially treated with argon plasma coagulation and clipped, which did not resolve the patient’s persistent anemia. No venous abnormalities were identified on computed tomography of the abdomen and pelvis with contrast. The patient underwent an endoscopically assisted exploratory laparoscopy that was converted to a laparotomy upon finding of grossly abnormal distal jejunum. Dilated and tortuous varicosities were identified involving approximately 150 cm of small bowel. It was decided to resect the 40 cm segment of jejunum in which varices were visible endoscopically. There was no evidence of thrombosis in the resected specimen. The patient suffered a pulmonary embolism post-operatively, believed to be provoked by the surgery.  The patient has had no re-bleeding 12 months post-resection. Literature Review: Both familial and non-familial accounts of small bowel varices in the absence of a primary cause have been reported in the literature. When supportive therapy is insufficient, the most common treatment modality chosen is surgical resection. Select cases have also demonstrated that sclerotherapy and varix dissection can be used for to treat these lesions. Conclusions:  Idiopathic small bowel varices pose both diagnostic and therapeutic challenges for physicians. In the literature, several treatment modalities have been shown to be successful; these include surgical resection, varix dissection and sclerotherapy. There is no consensus on the preferred treatment strategy. This report demonstrates endoscopically assisted surgical resection as a viable management strategy for bleeding of idiopathic small bowel varices, an uncommon cause of occult GI bleeding.

scholarly journals Impacted bone fragment in a small-bowel diverticulum: an extremely rare cause of obscure gastrointestinal bleeding

Endoscopy ◽  
2014 ◽  
Vol 46 (S 01) ◽  
pp. E262-E262
Author(s):  
Hazem Hammad ◽  
Leen Al-Sayyed ◽  
Shoba Theivanayagam ◽  
Van Nguyen ◽  
Arthur Rawlings ◽  
...  
Keyword(s):  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Obscure Gastrointestinal Bleeding ◽  
Bone Fragment

scholarly journals The Diagnostic Yields and Safety of Double-Balloon Enteroscopy in Obscure Gastrointestinal Bleeding and Incomplete Small Bowel Obstruction: Comparison between the Adults and Elderly

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Lei Wang ◽  
Mengfan Xie ◽  
Liwen Hong ◽  
Chen Zhang ◽  
Tianyu Zhang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
The Elderly ◽  
Obscure Gastrointestinal Bleeding ◽  
Double Balloon Enteroscopy ◽  
Balloon Enteroscopy ◽  
Double Balloon

Background. Double-balloon enteroscopy (DBE) is widely used worldwide. However, comparisons between the diagnostic yields in adults and the elderly remain scarce. Aim. The aim of this study is to compare the diagnostic yields and safety of DBE between adults and elderly with obscure gastrointestinal bleeding and incomplete small bowel obstruction. Method. We retrospectively reviewed patients who underwent DBE with indication of obscure gastrointestinal bleeding or incomplete small bowel obstruction in Ruijin Hospital and classified them into adults (18–64 years old) and elderly (≥65 years old). Clinical characteristics, diagnostic yields, and postoperative complications were collected and further analyzed. Results. A total of 877 DBE procedures, 729 in adults and 148 in the elderly, were performed. In the patients with OGIB, the adults showed a higher frequency of Meckel’s diverticulum compared with the elderly (4.6% vs. 0.9%, P=0.032). Angioectasia was higher in frequency in the elderly than in the adults (25.9% vs. 17.9%, P=0.048). In patients with incomplete small bowel obstruction, the elderly were more likely to have adenocarcinoma than the adults (19.4% vs. 7.1%, P=0.038). The adults had higher tendency to have Crohn’s disease than the elderly (23.4% vs. 8.3%, P=0.045). Most of the postoperative complications were mild. The adults and elderly displayed comparable tolerance to DBE (P>0.05) Conclusion. DBE has a high diagnostic yield in small bowel disorders, and a slight difference in disease spectrum was observed between the adults and elderly. DBE can be well-tolerated in the elderly.

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