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Evaluation of small bowel bleeding

Singh, Anupam; Baptista, Veronica; Stoicov, Calin; Cave, David R.

Current Opinion in Gastroenterology: March 2013 - Volume 29 - Issue 2 - p 119–124
doi: 10.1097/MOG.0b013e32835bdc1a
SMALL INTESTINE: Edited by David H. Alpers and William F. Stenson

Purpose of review: The review focuses on the latest techniques that are evolving in the management of small bowel bleeding.

Recent findings: Video capsule endoscopy has the highest yield of diagnosis when it is performed within 48 h of the bleeding event (78 versus 48%). The pooled detection rate of double balloon endoscopy was noted to be 68.1% for obscure gastrointestinal bleeding according to a systematic review of 66 studies in the last 10 years. Also a recent review, which focused on analysis of 68 studies found that the procedural characteristics were comparable for double balloon, single balloon and spiral enteroscopy though the procedure time was fastest for the spiral enteroscopy group. Medical therapy for vascular lesions is in its infancy but shows promise.

Summary: Advanced diagnostic and therapeutic endoscopic techniques are changing the paradigm of care for patients with small bowel bleeding.

UMassMemorial Medical Center, Worcester, Massachusetts, USA

Correspondence to David R. Cave, MD, PhD, UMassMemorial Medical Center, 55 Lake Avenue North, Worcester, MA 01655, USA. Tel: +1 508 856 8399; fax: +1 508 856 3981; e-mail: david.cave@umassmemorial.org

© 2013 Lippincott Williams & Wilkins, Inc.