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Diagnostic and therapeutic options in obscure gastrointestinal blood loss
1Division of Gastroenterology, University of Miami School of Medicine/ Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140, USA.
Obscure gastrointestinal bleeding is defined as an intermittent or chronic loss of blood manifested by iron deficiency anemia or overt bleeding the source of which has not been identified in upper endoscopy, colonoscopy, and barium studies. The diagnostic work-up includes repeat upper endoscopy and colonoscopy, push enteroscopy, radionuclide bleeding scan, angiography, and exploratory laparotomy with intra-operative enteroscopy. Recent publications regarding these and new diagnostic modalities, as well as advances in therapy, including combination hormonal therapy, are reviewed.
Obscure gastrointestinal bleeding is defined as an intermittent or chronic loss of blood manifested by iron deficiency anemia or overt bleeding the source of which has not been identified in upper endoscopy, colonoscopy, and barium studies. The diagnostic work-up includes repeat upper endoscopy and colonoscopy, push enteroscopy, radionuclide bleeding scan, angiography, and exploratory laparotomy with intra-operative enteroscopy. Recent publications regarding these and new diagnostic modalities, as well as advances in therapy, including combination hormonal therapy, are reviewed.
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