INTESTINE Vol.23 No.4(2-2)

Theme Obscure gastrointestinal bleeding (OGIB)
Title Small intestinal neoplastic lesions with obscure gastrointestinal bleeding
Publish Date 2019/08
Author Teppei Omori Institute of Gastroenterology, Tokyo Women's Medical University
[ Summary ] Small intestinal tumors may contribute to obscure gastrointestinal bleeding (OGIB). Early diagnosis can improve treatment results and contribute to favorable prognosis in patients. Clinical manifestations of small intestinal tumors are usually non-specific. However, small intestinal tumors are usually accompanied by a certain number of hemorrhages. Therefore, it is necessary to consider small intestinal tumors in the differential diagnosis in patients presenting with OGIB. Presently, balloon-assisted enteroscopy (BAE) and small bowel capsule endoscopy (SBCE) are widely used procedures. Selection of the optimal modality (BAE vs. SBCE) involves an initial contrast-enhanced computed tomography (CT) examination. If CT reveals abnormalities such as extravasation of blood and/or wall thickening, BAE is the preferred procedure; however, if CT reveals no abnormalities, SBCE is used for first-line screening purposes. Mutual and complementary use of these modalities is useful for early diagnosis.
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