Recurrent gastrointestinal bleeding of obscure origin: report of 17 cases and a guide to logical management

Br J Surg. 1983 Aug;70(8):489-93. doi: 10.1002/bjs.1800700812.

Abstract

Seventeen patients with chronic obscure gastrointestinal bleeding presenting over a 5-year period are described. While representing only 6 per cent of the total number of admissions due to gastrointestinal haemorrhage they required a disproportionate amount of medical attention, including 67 admissions, 73 radiological and 56 endoscopic procedures and transfusion of a total of 198 units of blood. The diagnoses included 5 cases of recurrent acute upper gastrointestinal erosions, 7 small bowel abnormalities and 4 colonic lesions, with 1 patient undiagnosed. Eight arteriovenous malformations (AVM) were demonstrated angiographically and one Meckel's diverticulum identified by a 99Tcm pertechnetate scan. There were 5 cases in which laparotomy yielded the final diagnosis and in one of these peroperative endoscopy of the small bowel was required. On the basis of our experience and a review of other series, a logical plan of investigation is described for such difficult cases.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Angiography
  • Chronic Disease
  • Colonic Diseases / diagnosis
  • Duodenal Diseases / diagnosis
  • Endoscopy
  • Enema
  • Female
  • Gastritis / diagnosis
  • Gastrointestinal Hemorrhage / diagnosis*
  • Humans
  • Intestinal Diseases / diagnosis
  • Intestine, Small
  • Laparotomy
  • Male
  • Middle Aged
  • Recurrence
  • Technetium

Substances

  • Technetium