Document Detail


Diagnostic evaluation and management of obscure gastrointestinal bleeding: a changing paradigm.
MedLine Citation:
PMID:  20567529     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Obscure gastrointestinal bleeding (OGIB) is defined as bleeding from the gastrointestinal tract that persists or recurs after a negative initial evaluation using bidirectional endoscopy and radiologic imaging with small-bowel radiograph. The main challenges related to evaluation of OGIB include the high miss rate for lesions on initial evaluation with standard endoscopy and the limited capacity of older diagnostic modalities to effectively examine the small bowel. The introduction of capsule endoscopy, balloon-assisted enteroscopy, spiral enteroscopy, and computed tomography (CT) enterography have served to overcome the limitations of older diagnostic tests. Capsule endoscopy is currently recommended as the third test of choice in the evaluation of patients with OGIB, after a negative bidirectional endoscopy. Balloon-assisted enteroscopy is useful for both the diagnosis and endoscopic management of OGIB. CT enterography is superior to small-bowel radiograph for luminal and extraluminal small-bowel examination. These advances in small-bowel diagnostics and the capacity to successfully perform endoscopic therapeutics have largely replaced surgical procedures and resulted in a trend toward noninvasive evaluation and endoscopic management of OGIB.
Authors:
Shabana F Pasha; Amy K Hara; Jonathan A Leighton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gastroenterology & hepatology     Volume:  5     ISSN:  1554-7914     ISO Abbreviation:  Gastroenterol Hepatol (N Y)     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2010-06-22     Completed Date:  2011-07-14     Revised Date:  2014-10-16    
Medline Journal Info:
Nlm Unique ID:  101262648     Medline TA:  Gastroenterol Hepatol (N Y)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  839-50     Citation Subset:  -    
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