Small bowel enteroscopy: an early experience in gastrointestinal bleeding of unknown origin.
Peroral small intestinal enteroscopy was performed in 35 consecutive patients with gastrointestinal bleeding of unknown origin by using a prototypic Sonde-type enteroscope. The median value for patient age was 69 years; duration of bleeding, 2 years (range, 2 months to 9 years); and transfusion requirements, 9 units. Bleeding was occult in 54% of these patients. Placement and passage of the enteroscope was performed by a gastrointestinal endoscopy assistant. Mean passage time was 4.3 hours. Complete passage was obtained in 14% of the patients, passage into the mid-distal ileum in 69%, and passage only into the jejunum in 17%. The diagnostic yield was 26%, with the majority of lesions encountered being mucosal vascular malformations. Small intestinal enteroscopy is a reasonable diagnostic procedure before embarking on visceral angiography and surgical exploration when standard endoscopic and radiologic methods fail to disclose a diagnosis.
Gostout
C J
CJ
Division of Gastroenterology and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
Schroeder
K W
KW
Burton
D D
DD
D000368:Aged; D001165:Arteriovenous Malformations / Q000150:complications / Q000175:diagnosis; D020776:Endoscopes, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007413:Intestinal Mucosa / Q000098:blood supply; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D013684:Telangiectasis / Q000150:complications / Q000175:diagnosis; D013997:Time Factors