title: Accurate diagnosis and successful treatment for massive obscure small intestinal bleeding by means of intra-operative enteroscopy: a case report.
abstract: Obscure gastrointestinal bleeding from the jejunum and ileum is always difficult to diagnose. Unstable patients with massive bleeding are not good candidates either for radiological studies or traditional endoscopic techniques. They usually need urgent operations to stop the bleeding. To identify the lesions, intraoperative enteroscopy is crucial for a better curing rate and for preventing massive unnecessary bowel resection. We report a 53-year-old unstable patient with massive obscure small intestinal bleeding. Urgent laparotomy with intraoperative enteroscopy was done. Two bleeding ulcers in the distal ileum were accurately identified and the diseased ileum was resected. Intraoperative enteroscopy may be a choice of diagnostic and therapeutic modality for unstable patients with obscure small intestinal bleeding.
authors.affiliation: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Po-Shun
authors.initials: PS
authors.lastname: Hsu
authors.forename: Jia-Lin
authors.initials: JL
authors.lastname: Chen
authors.forename: Jyh-Cherng
authors.initials: JC
authors.lastname: Yu
authors.forename: Chung-Bao
authors.initials: CB
authors.lastname: Hsieh
authors.forename: Ming-Lang
authors.initials: ML
authors.lastname: Shih
mesh_terms: D004630:Emergencies; D016099:Endoscopy, Gastrointestinal; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis* / Q000601:surgery; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014456:Ulcer / Q000150:complications / Q000175:diagnosis* / Q000601:surgery