Document Detail


The patient with recidivent obscure gastrointestinal bleeding.
MedLine Citation:
PMID:  17544107     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Obscure gastrointestinal (GI) bleeding is defined as visible or invisible GI blood loss, the source of which can not be identified by standard endoscopy (oesophagogastroduodenoscopy and colonoscopy). Nowadays, GI bleeding is divided into upper, mid- and lower bleeding. Mid-GI bleeding covers the section from the Treitz ligament to the ileocaecal valve. The new diagnostic methods of capsule endoscopy and double balloon enteroscopy have revolutionised the diagnostic approach in recent years. As a result, previous radiological and nuclear medicine techniques (small bowel X-ray, scintigraphy and angiography), but also endoscopic techniques, such as the push enteroscopy and intraoperative endoscopy, are becoming less important. After standard endoscopy and persistent blood loss it is advisable to first have these procedures repeated by an experienced examiner under optimal conditions. Nevertheless, no source of bleeding is identified by this method in 5% of cases. It is then recommended to use capsule endoscopy and, depending on the findings, double balloon enteroscopy with the option of intervention. In patients with unstable circulation an invasive procedure (intraoperative endoscopy) may be required.
Authors:
Ulrich Heil; Michael Jung
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Best practice & research. Clinical gastroenterology     Volume:  21     ISSN:  1521-6918     ISO Abbreviation:  Best Pract Res Clin Gastroenterol     Publication Date:  2007  
Date Detail:
Created Date:  2007-06-04     Completed Date:  2007-07-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101120605     Medline TA:  Best Pract Res Clin Gastroenterol     Country:  England    
Other Details:
Languages:  eng     Pagination:  393-407     Citation Subset:  IM    
Affiliation:
Klinik für Innere Medizin und Gastroenterologie, St.-Hildegardis-Krankenhaus, Katholisches Klinikum Mainz, Hildegardstrasse 2, 55131 Mainz, Germany. uli@heil-net.de
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MeSH Terms
Descriptor/Qualifier:
Endoscopy, Gastrointestinal
Gastrointestinal Hemorrhage / classification,  diagnosis*,  etiology,  therapy
Humans
Occult Blood

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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