Occult gastrointestinal bleeding. An evaluation of available diagnostic methods

Arch Surg. 1975 May;110(5):661-5. doi: 10.1001/archsurg.1975.01360110207036.


Occult gastrointestinal bleeding was defined as continued bleeding in spite of a normal series of roentgenorgrams of the upper part of the gastrointestinal tract, barium enema, and sigmoidoscopy. Twenty-six such patients were treated. A thorough systematic evaluation, including gastroscopy, colonoscopy, visceral angiography, and isotopic scanning, was done preoperatively. Using colonoscopy and arteriography, nearly 60% of the bleeding sites were identified. Seventy-six percent of the lesions identified were in the terminal part of the ileum or the ascending colon. Exploratory laparotomy should be performed for life-threatening hemorrhage or as a diagnostic test only after a thorough preoperative evaluation. If results of a complete preoperative evaluation including arteriography were normal, then the likelihood of finding a discrete cause of bleeding at laparotomy was high (80%). A systematic evaluation and diligence of both physcian and patient in localizing the site of bleeding are essential.

MeSH terms

  • Abdomen / blood supply
  • Adolescent
  • Adult
  • Aged
  • Angiography
  • Barium Sulfate
  • Child
  • Child, Preschool
  • Colon
  • Endoscopy
  • Enema
  • Female
  • Gastrointestinal Hemorrhage / diagnosis*
  • Gastrointestinal Hemorrhage / diagnostic imaging
  • Gastroscopy
  • Humans
  • Laparotomy
  • Male
  • Methods
  • Middle Aged
  • Occult Blood*
  • Sigmoidoscopy


  • Barium Sulfate