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Small bowel bleeding: a comprehensive review.

Deepak Gunjan1, Vishal Sharma1, Surinder S Rana2

  • 1Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Gastroenterology Report
|May 31, 2014
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Summary
This summary is machine-generated.

Small intestine bleeding is rare but often obscure, commonly caused by angiodysplasia in the elderly. Advanced endoscopic techniques improve diagnosis and treatment of these challenging gastro-intestinal bleeds.

Keywords:
aetiologydiagnostic approachmanagementsmall intestine bleed

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Area of Science:

  • Gastroenterology
  • Digestive Endoscopy

Background:

  • Small intestine bleeding is an uncommon cause of gastro-intestinal (GI) bleeding but the most frequent cause of obscure GI bleeding.
  • Obscure GI bleeding often necessitates multiple transfusions, diagnostic procedures, and hospitalizations.
  • Angiodysplasia is the leading cause of obscure GI bleeding, particularly in elderly patients, while inflammatory lesions and tumors are more common in younger individuals.

Purpose of the Study:

  • To review the diagnostic and therapeutic strategies for small intestinal bleeding.
  • To highlight the role of advanced endoscopic techniques in managing obscure GI bleeding.

Main Methods:

  • Review of current literature on small intestinal bleeding.
  • Discussion of diagnostic modalities including capsule endoscopy, deep enteroscopy, and computed tomography.
  • Exploration of therapeutic options ranging from conservative management to surgical intervention.

Main Results:

  • Capsule endoscopy and deep enteroscopy have significantly improved the investigation of small bowel bleeds.
  • Deep enteroscopy offers therapeutic potential in addition to diagnostic capabilities.
  • Computed tomography aids in identifying extra-intestinal lesions, and surgery with intra-operative enteroscopy can be crucial for difficult diagnoses.

Conclusions:

  • Small intestinal bleeding management is etiology-dependent, requiring tailored approaches.
  • Treatment strategies encompass conservative, radiological, pharmacological, endoscopic, and surgical methods.
  • Recurrent bleeding, especially from multiple vascular lesions, presents a significant clinical challenge.