| [ Summary ] |
We review the diagnostic and therapeutic strategies for obscure gastrointestinal bleeding in children. We recommend abdominal ultrasonography as the first-line approach in all cases. Subsequently, an esophagogastroduodenoscopy is recommended in patients with tarry stools, followed by capsule endoscopy if a bleeding source is not identified. In contrast, we first perform retrograde (anal route) balloon-assisted enteroscopy after bowel preparation in patients with dark red blood in stools, with both, endoscopic observation and contrast-enhanced fluoroscopic imaging to detect Meckel's diverticulum. If the enteroscopy does not detect the source of bleeding, a Meckel's scan, capsule endoscopy, antegrade (oral route) balloon-assisted enteroscopy, CT, or magnetic resonance imaging can be considered. Treatment is based on the underlying disease and condition. |