| [ Summary ] |
For gastrointestinal bleeding without visible abnormalities on upper gastrointestinal endoscopy or colonoscopy, a dynamic computed tomography (CT) scan should be performed first. If any abnormalities are found on CT, balloon assisted endoscopy should be performed via a route near the lesion. If no abnormality is found on CT, capsule endoscopy should be performed. Depending on the findings of capsule endoscopy, medication, surgery, observation, balloon‒assisted endoscopy or Meckel diverticulum scintigraphy should be selected. A distal attachment on the tip of the scope is should be used. The oral route should be selected for an ongoing bleeding case. To find the bleeding point, marking‒clip placement, underwater observation, and gel immersion endoscopy are useful. Most small intestinal vascular lesions can be treated endoscopically. The method of hemostasis should be selected depending on the endoscopic classification of small intestinal vascular lesions with respect to the presence or absence of pulsation. |