Skip to main content

The Unstable Patient with Obscure Gastrointestinal Bleeding: Surgical and Nonsurgical Management

  • Chapter
  • First Online:
Gastrointestinal Bleeding

Abstract

Obscure gastrointestinal bleeding (OGIB) is defined as intermittent or persistent loss of blood that occurs or reoccurs after evaluation by upper gastrointestinal and lower gastrointestinal endoscopy [Zuckerman et al. Gastroenterology 118:201–221, 2000]. The clinical presentation can vary dramatically, from occult blood loss that is only detectible by hemoccult testing, manifesting as iron deficiency to overt clinical manifestations of hematemesis, melena, or hematochezia requiring transfusion and hospitalization.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Zuckerman GR, Prakash C, Askin MP, Lewis BS. AGA technical review on the evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology. 2000;118:201–21.

    Google Scholar 

  2. Concha R, Amaro R, Barkin JS. Obscure gastrointestinal bleeding: diagnostic and therapeutic approach. J Clin Gastroenterol. 2007;41(3):242–51.

    Article  PubMed  Google Scholar 

  3. Mujica VR, Barkin JS. Occult gastrointestinal bleeding. General overview and approach. Gastrointest Endosc Clin NA. 1996;6:833–45.

    CAS  Google Scholar 

  4. Lewis BS, Kornbluth A, Waye JD. Small bowel tumours: yield of enteroscopy. Gut. 1991;32:763–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Descamps C, Schmit A, van Gossum A. “Missed” upper gastrointestinal tract lesions may explain “occult” bleeding. Endoscopy. 1999;31:452–5.

    Article  CAS  PubMed  Google Scholar 

  6. Spiller RC, Parkins RA. Recurrent gastrointestinal bleeding of obscure origin: report of 7 cases and a guide to logical management. Br J Surg. 1983;70:489–93.

    Article  CAS  PubMed  Google Scholar 

  7. Barkin JS, Lewis BS, Reiner DK, Waye JD, Goldberg RI, Phillips RS. Diagnostic and therapeutic jejunoscopy with a new, longer enteroscope. Gastrointest Endosc. 1992;38:55–8.

    Google Scholar 

  8. Chong J, Tagle M, Barkin JS, Reiner DK. Small bowel push-type fiberoptic enteroscopy for patients with occult gastrointestinal bleeding or suspected small bowel pathology. Am J Gastroenterol. 1994;89:2143–6.

    Google Scholar 

  9. Zaman A, Katon RM. Push enteroscopy for obscure gastrointestinal bleeding yields a high incidence of proximal lesions within reach of a standard endoscope. Gastrointest Endosc. 1998;47:372–6.

    Article  CAS  PubMed  Google Scholar 

  10. Chak A, Koehler MK, Sundaram SN, Cooper GS, Canto MI, Sivak MV Jr. Diagnostic and therapeutic impact of push enteroscopy: analysis of factors associated with positive findings. Gastrointest Endosc. 1998;47:18–22.

    Google Scholar 

  11. Willis JR, Chokshi HR, Zuckerman GR, Aliperti G. Enteroscopy-enteroclysis: experience with a combined endoscopic-radiographic technique. Gastrointest Endosc. 1997;45:163–7.

    Google Scholar 

  12. Vakil N, Huilgol V, Khan I. Effect of push enteroscopy on transfusion requirements and quality of life in patients with unexplained gastrointestinal bleeding. Am J Gastroenterol. 1997;92:425–8.

    CAS  PubMed  Google Scholar 

  13. Chen RY, Taylor AC, Desmond PV. Push enteroscopy: a single centre experience and review of published series. ANZ J Surg. 2002;72:215–8.

    Article  PubMed  Google Scholar 

  14. Retzlaff JA, Hagedorn AB, Bartholomew LG. Abdominal exploration for gastrointestinal bleeding of obscure origin. JAMA. 1961;177:104–7.

    Article  CAS  PubMed  Google Scholar 

  15. Lewis MP, Khoo DE, Spencer J. Value of laparotomy in the diagnosis of obscure gastrointestinal haemorrhage. Gut. 1995;37:187–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Ba MC, Qing SH, Huang XC, Wen Y, Li GX, Yu J. Application of laparoscopy in diagnosis and treatment of massive small intestinal bleeding: report of 22 cases. World J Gastroenterol. 2006;12:7051–4.

    Google Scholar 

  17. Pei K, Zemon H, Venbrux A, Brody F. Laparoscopic techniques for occult gastrointestinal bleeding. J Laparoendosc Adv Surg Tech. 2005;15:615–9.

    Google Scholar 

  18. Lee K, Yeung C, Tam Y, Ng WT, Yip KF. Laparoscopy for definitive diagnosis and treatment of gastrointestinal bleeding of obscure origin in children. J Pediatr Surg. 2000;35:1291–3.

    Google Scholar 

  19. Heil U, Jung M. The patient with recidivent obscure gastrointestinal bleeding. Best Pract Res Clin Gastroenterol. 2007;21:393–407.

    Article  PubMed  Google Scholar 

  20. Barlow JM, Goss BC, Hansel SL, et al. CT enterography: technical and interpretive pitfalls. Abdom Imaging. 2015;40:1081–96.

    Article  PubMed  Google Scholar 

  21. Lin S, Rockey DC. Obscure gastrointestinal bleeding. Gastroenterol Clin North Am. 2005;34:679–98.

    Article  PubMed  Google Scholar 

  22. Rondonotti E, Marmo R, Petracchini M, et al. The American Society for Gastrointestinal Endoscopy (ASGE) diagnostic algorithm for obscure gastrointestinal bleeding: Eight Burning questions from everyday clinical practice. Dig Liver Dis. 2013;45:179–85.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rebecca P. Petersen M.D., M.Sc. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing AG

About this chapter

Cite this chapter

Petersen, R.P., Pryor, A.D. (2016). The Unstable Patient with Obscure Gastrointestinal Bleeding: Surgical and Nonsurgical Management. In: Pryor, A., Pappas, T., Branch, M. (eds) Gastrointestinal Bleeding. Springer, Cham. https://doi.org/10.1007/978-3-319-40646-6_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-40646-6_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-40644-2

  • Online ISBN: 978-3-319-40646-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics