Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014 Aug 15;5(3):271-83.
doi: 10.4291/wjgp.v5.i3.271.

New insights to occult gastrointestinal bleeding: From pathophysiology to therapeutics

Antonio Damián Sánchez-Capilla  1 , Paloma De La Torre-Rubio  1 , Eduardo Redondo-Cerezo  1
Affiliations
Review

New insights to occult gastrointestinal bleeding: From pathophysiology to therapeutics

Antonio Damián Sánchez-Capilla et al. World J Gastrointest Pathophysiol. .

Abstract

Obscure gastrointestinal bleeding is still a clinical challenge for gastroenterologists. The recent development of novel technologies for the diagnosis and treatment of different bleeding causes has allowed a better management of patients, but it also determines the need of a deeper comprehension of pathophysiology and the analysis of local expertise in order to develop a rational management algorithm. Obscure gastrointestinal bleeding can be divided in occult, when a positive occult blood fecal test is the main manifestation, and overt, when external sings of bleeding are visible. In this paper we are going to focus on overt gastrointestinal bleeding, describing the physiopathology of the most usual causes, analyzing the diagnostic procedures available, from the most classical to the novel ones, and establishing a standard algorithm which can be adapted depending on the local expertise or availability. Finally, we will review the main therapeutic options for this complex and not so uncommon clinical problem.

Keywords: Angiodysplasia; Double balloon enteroscopy; Obscure gastrointestinal bleeding; Wireless capsule endoscopy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Proposal of a diagnostic algorithm. OGIB: Obscure gastrointestinal bleeding; WCE: Wireless capsule endoscopy; DBE: Double balloon enteroscopy; PE: Push enteroscopy; IE: Intraoperative enteroscopy.
See this image and copyright information in PMC

References

    1. Ell C, May A. Mid-gastrointestinal bleeding: capsule endoscopy and push-and-pull enteroscopy give rise to a new medical term. Endoscopy. 2006;38:73–75. - PubMed
    1. Prakash C, Zuckerman GR. Acute small bowel bleeding: a distinct entity with significantly different economic implications compared with GI bleeding from other locations. Gastrointest Endosc. 2003;58:330–335. - PubMed
    1. Moawad FJ, Veerappan GR, Wong RK. Small bowel is the primary source of obscure gastrointestinal bleeding. Gastroenterology. 2008;135:1016. - PubMed
    1. Gralnek IM. Obscure-overt gastrointestinal bleeding. Gastroenterology. 2005;128:1424–1430. - PubMed
    1. Raju GS, Gerson L, Das A, Lewis B. American Gastroenterological Association (AGA) Institute technical review on obscure gastrointestinal bleeding. Gastroenterology. 2007;133:1697–1717. - PubMed