title: Obscure and occult gastrointestinal bleeding: comparison of different imaging modalities.
abstract: Patients with persistent, recurrent, or intermittent bleeding from the gastrointestinal (GI) tract for which no definite cause has been identified by initial esophagogastroduodenoscopy, colonoscopy, or conventional radiologic evaluation are considered to have an obscure GI bleeding (OGIB). The diagnosis and management of patients with OGIB is challenging, often requiring extensive and expensive workups. The main objective is the identification of the etiology and site of bleeding, which should be as rapidly accomplished as possible, in order to establish the most appropriate therapy. The introduction of capsule endoscopy and double balloon enteroscopy and the recent improvements in CT and MRI techniques have revolutionized the approach to patients with OGIB, allowing the visualization of the entire GI tract, particularly the small bowel, until now considered as the "dark continent" . In this article we review and compare the radiologic and endoscopic examinations currently used in occult and OGIB, focusing on diagnostic patterns, pitfalls, strengths, weaknesses, and value in patients' management.
authors.affiliation: Department of Neurosciences and Imaging, Section of Radiological Imaging, "G. d'Annunzio" University, Chieti, Italy. a.filippone@rad.unich.it
authors.forename: Antonella
authors.initials: A
authors.lastname: Filippone
authors.forename: Roberta
authors.initials: R
authors.lastname: Cianci
authors.forename: Angelo
authors.initials: A
authors.lastname: Milano
authors.forename: Erika
authors.initials: E
authors.lastname: Pace
authors.forename: Matteo
authors.initials: M
authors.lastname: Neri
authors.forename: Antonio Raffaele
authors.initials: AR
authors.lastname: Cotroneo
mesh_terms: D053704:Capsule Endoscopy; D003287:Contrast Media / Q000008:administration & dosage; D016099:Endoscopy, Gastrointestinal; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D061330:Multidetector Computed Tomography; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media