Occult gastrointestinal bleeding. An evaluation of available diagnostic methods.
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.
D000005:Abdomen / Q000098:blood supply; D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D001466:Barium Sulfate; D002648:Child; D002675:Child, Preschool; D003106:Colon; D004724:Endoscopy; D004733:Enema; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005773:Gastroscopy; D006801:Humans; D007813:Laparotomy; D008297:Male; D008722:Methods; D008875:Middle Aged; D009780:Occult Blood; D012812:Sigmoidoscopy
D001466:Barium Sulfate