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Small Bowel Bleeding: Updated Algorithm and Outcomes
1Division of Gastroenterology, Department of Medicine, California Pacific Medical Center, University of California, San Francisco, 2340 Clay Street, 6th Floor, San Francisco, CA 94115, USA.
Insights
The classification of obscure gastrointestinal hemorrhage has been updated to suspected small bowel bleeding. This article outlines management algorithms for this condition using various diagnostic tools.
Area of Science:
- Gastroenterology
- Diagnostic Imaging
- Endoscopy
Background:
- The term "obscure gastrointestinal hemorrhage" is outdated.
- Current guidelines recommend classifying these cases as "suspected small bowel bleeding".
Purpose of the Study:
- To provide updated management algorithms for suspected small bowel bleeding.
- To guide clinicians in utilizing advanced diagnostic techniques.
Main Methods:
- Review of the 2015 American College of Gastroenterology guidelines.
- Development of clinical algorithms for suspected small bowel bleeding.
- Integration of diagnostic modalities such as video capsule endoscopy, CT enterography, MR enterography, angiography, and deep enteroscopy.
Main Results:
- A shift in terminology from obscure gastrointestinal hemorrhage to suspected small bowel bleeding.
- Defined pathways for patient management incorporating multiple diagnostic tools.
Conclusions:
- The updated classification necessitates revised management strategies.
- A systematic approach utilizing advanced endoscopic and imaging techniques is crucial for diagnosing small bowel bleeding.
Abstract:
Patients previously classified with "obscure gastrointestinal hemorrhage" should now be classified as "suspected small bowel bleeding" according to the 2015 American College of Gastroenterology guidelines. This article provides algorithms for how to manage patients with suspected small bowel bleeding, including utilization of second-look endoscopy and/or colonoscopy, video capsule endoscopy, computed tomographic enterography, magnetic resonance enterography, angiography, and deep enteroscopy.
