Total intraoperative enteroscopy using a colonoscope for detecting the bleeding point

Area of Science:

• Gastroenterology
• Surgical Endoscopy

Background:

• Small intestine bleeding is rare and challenging to diagnose.
• Obscure gastrointestinal bleeding can lead to severe conditions and shock.

Purpose of the Study:

• To report a case of successful diagnosis and treatment of small intestine bleeding using total intraoperative enteroscopy.
• To highlight the efficacy of intraoperative enteroscopy for identifying obscure gastrointestinal bleeding sources.

Main Methods:

• A 59-year-old male patient with severe gastrointestinal bleeding underwent emergency laparotomy.
• Total intraoperative enteroscopy was performed using a colonoscope to identify the bleeding source.
• A jejunal ulceration, diagnosed as angiodysplasia, was found and surgically resected.

Main Results:

• Gastroscopy, colonoscopy, arteriography, and scintigraphy failed to localize the bleeding.
• Total intraoperative enteroscopy successfully identified a jejunal angiodysplasia as the source of bleeding.
• The patient recovered fully and was discharged on postoperative day 24.

Conclusions:

• Total intraoperative enteroscopy is an effective tool for diagnosing obscure small intestine bleeding when other methods fail.
• This technique is feasible in most centers without specialized equipment.
• Early diagnosis and intervention are crucial for managing severe small intestine bleeding.