Intra-operative enteroscopy for obscure gastrointestinal bleeding.

Area of Science:

• Gastroenterology
• Surgical Endoscopy

Background:

• Obscure gastrointestinal bleeding (OGIB) diagnosis is challenging due to limitations in standard small bowel enteroscopy.
• Intra-operative enteroscopy (IOE) provides complete visualization of the small intestine during surgery.

Observation:

• Two patients with OGIB and severe anemia underwent surgical exploration with IOE.
• The first patient had a 3 cm jejunal angiodysplastic lesion identified and resected.
• The second patient presented with diffuse small punctate lesions throughout the jejunum and ileum, necessitating total jejunal resection.

Findings:

• IOE successfully identified the sources of obscure gastrointestinal bleeding in both patients.
• Surgical intervention based on IOE findings led to complete resolution of bleeding.
• No recurrence of gastrointestinal bleeding was observed during a 36-month follow-up period.

Implications:

• IOE is a definitive diagnostic and therapeutic tool for complex cases of obscure gastrointestinal bleeding.
• This approach can significantly improve patient outcomes by enabling complete small bowel evaluation and targeted resection.
• IOE facilitates accurate diagnosis and management of small bowel lesions, potentially reducing the need for repeated investigations.