Gastrointestinal bleeding of obscure origin: role of enteroclysis

Antes, Günther; Neher, M; Hiemeyer, V.; Burger, A.

doi:10.1007/bf00240688

Cited by 31 publications

(12 citation statements)

References 10 publications

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“…CTE performed for chronic obscure gastrointestinal bleeding or unexplained anemia tends to show a high rate of negative findings similar to conventional enteroclysis, with a reported diagnostic yield as low as 10-20% [52,53]. Up to now, these figures have been confirmed only by one prospective comparison of CTE with wireless capsule endoscopy (WCE): CTE performed on eight patients with obscure gastrointestinal bleeding only resulted in one positive finding, which was suspected jejunal angioma.…”

Section: Small Bowel Neoplasmsmentioning

confidence: 99%

“…contrastenhanced mucosa and submucosal edema (arrowheads). Surgical and histopathological findings confirmed the diagnosis of multiple carcinoid tumors of the ileum a with desmoplastic reaction of the mesentery and secondary ischemia of the adjacent ileal wall due to perivascular tumor infiltration (b) Chronic obscure GI bleeding Arteriovenous malformations are the most frequent source of chronic obscure GI bleeding occurring in 39-80% of patients, followed by neoplasms (6-15%) and rare causes, such as jejunal, duodenal or Meckel's diverticula, segmentary ischemia, Crohn's' disease or radiation enteritis [10,46,52].…”

Section: Small Bowel Neoplasmsmentioning

confidence: 99%

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CT enteroclysis: technique and clinical applications

et al. 2005

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CT enteroclysis: technique and clinical applicationsAbstract CT enteroclysis (CTE) has been gradually evolving with technical developments of spiral and multidetector row CT technology. It has nowadays become a well-defined imaging modality for the evaluation of various small bowel disorders. Volume challenge of 2L of enteral contrast agent administrated to the small bowel via a nasojejunal catheter ensures luminal distension, the prerequisite for the detection of mural abnormalities, also facilitating the accurate visualization of intraluminal lesions. CT acquisition is centered on small bowel loops, reconstructed in thin axial slices and completed by multiplanar views. Image analysis is essentially done in cine-mode on work-stations. CTE is of particular diagnostic value in intermediate or advanced stages of Cohn's disease, including the depiction of extraintestinal complications. It has become the imaging modality of choice for the localization and characterization of small bowel tumors. The cause and degree of low-grade small bowel obstruction is more readily analyzed with the technique of CTE than conventional CT. Limitations of CTE concern the assessment of pure intestinal motility disorders, superficial mucosal lesions and arteriovenous malformations of the small bowel, which are not consistently visualized. CTE should be selectively used to answer specific questions of the small bowel. It essentially contributes to the diagnostic quality of modern small bowel imaging, and therefore deserves an established, well-defined place among the other available techniques.

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Section: Small Bowel Neoplasmsmentioning

confidence: 99%

Section: Small Bowel Neoplasmsmentioning

confidence: 99%

CT enteroclysis: technique and clinical applications

et al. 2005

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“…(7)(8)(9)(10)(11)(12). For gastrointestinal bleeding the diagnostic yields range from 10 to 25% (13)(14)(15).…”

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confidence: 99%

A Retrospective Review of Enteroclysis in Patients with Obscure Gastrointestinal Bleeding and Chronic Abdominal Pain of Undetermined Etiology

et al. 2005

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Our purpose was to determine the diagnostic utility of enteroclysis in the evaluation of obscure gastrointestinal bleeding and abdominal pain of unknown etiology. This is a retrospective review of 97 consecutive patients (mean age, 54.1+/-17.5 [SD] years; 49 male and 48 female) who underwent enteroclysis at Temple University Hospital from January 1994 to October 2001 for the evaluation of obscure GI bleeding or chronic abdominal pain of undetermined etiology. Prior to enteroclysis all patients had an EGD and colonoscopy, which were nondiagnostic for their symptoms. Sixty-three patients (64.9%) had enteroscopy performed prior to enteroclysis that was also negative. Enteroclysis results were defined as positive based on anatomical or functional abnormalities. Analysis of the data included the percentage yield of positive exams, the percentage of positive results per symptom category, and the percentage of patients with a change in clinical management based on positive enteroclysis results. Ninety-seven patients underwent enteroclysis. The indications for enteroclysis were obscure GI bleeding in 67 patients (69.1%) and chronic abdominal pain in 30 patients (30.9%). The number of positive exams was 19 (19.6%). Fourteen of the 67 patients with the indication of GI bleeding had a positive exam (21%), while 5 of the 30 patients with chronic abdominal pain had a positive result (16.7%). There was a change in clinical management due to the enteroclysis results in 10 patients: 7 patients with GI bleeding (10%) and 3 patients with chronic abdominal pain (10%). Positive enteroclysis findings included adhesions (7), filling defects and masses (5), strictures (2), small bowel diverticulosis (1), mucosal abnormalities (3), and a motility disorder (1). The overall positive yield for enteroclysis was 19.6%, with a yield of 16.7% for chronic abdominal pain and 21% for gastrointestinal bleeding. Enteroclysis results changed the clinical management in approximately 10% of the patients.

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“…Although the precise incidence remains uncertain, S-B varices are considered to be very rare; the literature includes fewer than 100 cases [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Although rare, a persistent and frustrating, often massive, bleeding remains a major source of clinical morbidity in S-B varices patients.…”

Section: Discussionmentioning

confidence: 99%

Small bowel varices: report of two cases

et al. 1998

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Two cases of small bowel (S-B) varices associated with portal hypertension, one with liver cirrhosis and one with portal thrombus, are reported. Detection of S-B varices has been a challenging task and several invasive diagnostic techniques have been used for this purpose. However, in our cases, color Doppler sonography revealed the S-B varices supplied by the superior mesenteric vein and draining to the iliac (one case) or ovarian vein (other case), which helped to establish an early appropriate diagnostic and treatment plan.

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Gastrointestinal bleeding of obscure origin: role of enteroclysis

Cited by 31 publications

References 10 publications

CT enteroclysis: technique and clinical applications

CT enteroclysis: technique and clinical applications

A Retrospective Review of Enteroclysis in Patients with Obscure Gastrointestinal Bleeding and Chronic Abdominal Pain of Undetermined Etiology

Small bowel varices: report of two cases

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