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Gastrointestinal bleeding of obscure origin: role of enteroclysis
1Department of Radiology, Klinikum Kempten-Oberallgäu, Germany.
Insights
Enteroclysis effectively diagnosed the source of obscure gastrointestinal bleeding in 11% of patients. This diagnostic imaging method correlated initial bleeding severity with recurrence rates, aiding in patient management.
Area of Science:
- Gastroenterology
- Diagnostic Imaging
- Medical Diagnostics
Background:
- Obscure gastrointestinal bleeding (GIB) presents a diagnostic challenge.
- Enteroclysis is an imaging technique used to visualize the small intestine.
Purpose of the Study:
- To retrospectively evaluate the diagnostic yield of enteroclysis for obscure GIB.
- To correlate bleeding severity with recurrence rates in patients with GIB.
Main Methods:
- Retrospective analysis of 124 patients with obscure GIB who underwent enteroclysis.
- Follow-up questionnaires were used to assess bleeding recurrence in 61 patients.
Main Results:
- Enteroclysis identified the source of bleeding in 11% of patients (14 positive, 2 negative, 1 false positive).
- A positive correlation was observed between the initial degree of hemorrhage and bleeding recurrence.
- Minor hemorrhage cases showed a low rate of recurrence.
Conclusions:
- Enteroclysis is a valuable tool for diagnosing obscure GIB, particularly when other methods fail.
- Understanding bleeding severity aids in predicting recurrence and managing patients with GIB.
Abstract:
The purpose of this work was to assess retrospectively the yield of enteroclysis in 124 unselected patients presenting with obscure gastrointestinal bleeding. Of 1000 consecutive patients who were examined by enteroclysis 124 presented with occult gastrointestinal bleeding. A total of 61 patients with an unknown source of bleeding at the time of discharge, but with established gastrointestinal bleeding, were followed up by questionnaire to correlate the initial degree of bleeding with the incidence of recurrence of bleeding. Enteroclysis was normal in 109 cases. An abnormality was found subsequently be the cause of bleeding in the small intestine in 16 patients. Enteroclysis was positive in 14 cases, negative in 2 and false positive in 1. There was positive correlation between the initial degree of haemorrhage and the rate of recurrence. Enteroclysis detected the cause in 11% of patients who presented with bleeding of unknown origin. In patients with minor haemorrhage there was no recurrence of bleeding in most cases.