Therapeutic management options for patients with obscure gastrointestinal bleeding

Kochhar, Gursimran; Sanaka, Madhusudhan R.; Vargo, John J.

doi:10.1177/1756283x11409280

Cited by 8 publications

(1 citation statement)

References 67 publications

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“…Aortoenteric fistula, Meckel’s diverticulum (MD) and polyps are some of the other less-known causes of OGIB. 3 …”

Section: Introductionmentioning

confidence: 99%

Severe obscure gastrointestinal bleeding from Meckel’s diverticulum with predominant ectopic pancreatic tissue

Jayawickrama,

Mohamed Ozaal,

Ranaweera

et al. 2024

SAGE Open Medical Case Reports

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Obscure gastrointestinal bleeding represents about 5% of all gastrointestinal haemorrhages which is characterized by continuous or recurrent bleeding from an undetermined source after an initial bidirectional endoscopy. Meckel’s diverticulum is a rare but recognized cause of obscure gastrointestinal bleeding. A carefully selected line of investigations is paramount to localize the causative lesion in obscure gastrointestinal bleeding which is a challenge in subacute cases. We present a case of 35-year-old female with thalassemia minor and mild anaemia presented with acute gastrointestinal bleeding from the ectopic pancreatic mucosa of an Meckel’s diverticulum where only a small focus of gastric tissue was identified histologically during the follow-up. This case discusses the rarity of this histological presentation of Meckel’s diverticulum as obscure gastrointestinal bleeding and the importance of intraoperative decision-making and intraoperative enteroscopy in cases of obscure gastrointestinal bleeding when other tests are negative.

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“…Aortoenteric fistula, Meckel’s diverticulum (MD) and polyps are some of the other less-known causes of OGIB. 3 …”

Section: Introductionmentioning

confidence: 99%

Severe obscure gastrointestinal bleeding from Meckel’s diverticulum with predominant ectopic pancreatic tissue

Jayawickrama,

Mohamed Ozaal,

Ranaweera

et al. 2024

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

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Preoperative Superselective Mesenteric Angiography and Methylene Blue Injection for Localization of Obscure Gastrointestinal Bleeding

et al. 2013

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Localizing obscure gastrointestinal bleeding can be a clinical challenge, despite the availability of various endoscopic, imaging, and visceral angiographic techniques. We reviewed the management of patients presenting with obscure gastrointestinal bleeding during the period from 2005 to 2011. Four patients had preoperative localization of the bleeding site with superselective mesenteric angiography, which was confirmed by the use of intraoperative methylene blue injection. This novel technique allowed us to identify the abnormal pathology, and, consequently, resection of the implicated segment of small bowel was performed without any postoperative complications. Final histology showed that 2 patients had arteriovenous malformations: one had a benign hemangioma of the small bowel, and the other had chronic ischemic ulceration in the ileum. Superselective mesenteric angiography combined with intraoperative localization with methylene blue is an important and innovative technique in the management of patients with unclear sources of gastrointestinal bleeding and allows for effective hemorrhage control with a focused and therefore limited bowel resection.

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Recurrence rates and risk factors in obscure gastrointestinal bleeding

Onishi,

Iwashita,

Tezuka

et al. 2024

DEN Open

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Obscure gastrointestinal bleeding (OGIB), defined in 2010, involves bleeding from the GI tract that remains unexplained after standard diagnostic procedures. OGIB, which accounts for about 5% of all GI bleeds, poses diagnostic and management challenges, particularly due to the anatomical features of the small intestine. Advances in capsule endoscopy (CE) and balloon‐assisted endoscopy have improved the diagnostic and therapeutic landscape for small intestinal lesions.ObjectiveTo determine the recurrence rate and identify risk factors for recurrence following diagnostic and therapeutic interventions using CE and balloon‐assisted endoscopy in patients with OGIB.MethodsA retrospective cohort study at Gifu University Hospital analyzed CE procedures for patients with OGIB from 2008 to 2022. Patients underwent CE with subsequent treatments based on the findings. Statistical analyses, including Kaplan‐Meier and Cox proportional hazards models, were used to estimate cumulative recurrence rates and identify recurrence risk factors.ResultsOut of 417 patients, 65.2% had positive CE findings, leading to therapeutic interventions in 16.3% of cases. The cumulative recurrence rates at 12, 24, and 36 months were 4.3%, 9.0%, and 13.9%, respectively. Liver cirrhosis (hazard rate: 4.15, 95% confidence interval 1.88–9.18, p < 0.01) was identified as a significant risk factor for recurrence.ConclusionsA significant recurrence rate in OGIB patients, with liver cirrhosis being a major risk factor. Despite diagnostic and therapeutic advances, a comprehensive approach including careful follow‐up and consideration of risk factors is essential for management.

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Therapeutic management options for patients with obscure gastrointestinal bleeding

Cited by 8 publications

References 67 publications

Severe obscure gastrointestinal bleeding from Meckel’s diverticulum with predominant ectopic pancreatic tissue

Severe obscure gastrointestinal bleeding from Meckel’s diverticulum with predominant ectopic pancreatic tissue

Preoperative Superselective Mesenteric Angiography and Methylene Blue Injection for Localization of Obscure Gastrointestinal Bleeding

Recurrence rates and risk factors in obscure gastrointestinal bleeding

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