Enteroclysis in obscure gastrointestinal system hemorrhage of small bowel origin

The diagnostic value of enteroclysis in patients with obscure gastrointestinal bleeding of small bowel origin was evaluated. Further diagnostic approaches in patients in whom enteroclysis did not yield a source for bleeding are discussed.

A total of 62 patients with gastrointestinal bleeding of obscure origin were retrospectively evaluated by enteroclysis. Patients in whom a specific pathology could not be identified on enteroclysis were further followed-up clinically and by laboratory examinations. Recurrent gastrointestinal bleeding had been considered an indication for further diagnostic evaluation.

Accurate cause of the pathology which may explain the source of bleeding was achieved via enteroclysis in 29 of the patients. Of the pathologies, most were inflammatory bowel disease (n=18), followed by neoplasms (n=4), malabsorption (n=3) and miscellaneous disorders (n=4). Thirty-three patients had normal findings on enteroclysis. Six patients were diagnosed as angiodysplasia on angiography and nine patients had either gastritis or duodenitis. A final diagnosis to explain the source of bleeding could not be achieved in 18 cases.

Enteroclysis provides essential information in gastrointestinal bleeding of obscure origin and its role in the diagnosis should not be undermined. Recurrent and consistent GI bleeding should be considered an indication for further diagnostic evaluation.