| Theme |
Obscure gastrointestinal bleeding (OGIB) |
| Title |
Therapeutic strategy for small intestinal bleeding lesions |
| Author |
Tomonori Yano |
Division of Gastroenterology, Department of Medicine, Jichi Medical University |
| [ Summary ] |
Balloon-assisted enteroscopy enables endoscopic diagnosis and treatment of small intestinal lesions. Causes of small intestinal bleeding include vascular, inflammatory, and neoplastic lesions, as well as a diverticulum. Most vascular lesions can be treated endoscopically. Inflammatory lesions are usually treated with medication. Neoplastic lesions and Meckel's diverticulum are often treated surgically. Endoscopes with a large accessory channel and cylindrical hood are useful for endoscopic hemostasis in patients with overt ongoing bleeding. When bloodtinged intestinal fluid is observed during oral insertion of the endoscope, a clip should be placed as a landmark because it is likely that the source of bleeding is close to this site. Gel immersion endoscopy is useful for visualization of the operative field when the source of bleeding is covered with blood and cannot be identified. |