Review Article

The Diagnosis and Investigation of Obscure Gastrointestinal Bleeding

K. Liu; A. J. Kaffes

Disclosures

Aliment Pharmacol Ther. 2011;34(14):416-423. 

In This Article

Small Bowel Follow-through, Conventional Enteroclysis, CT Enterography and CT Enteroclysis

Capsule endoscopy and DBE have largely eliminated the role of radiographic studies such as small bowel series and conventional enteroclysis in the evaluation of obscure GI bleeding. The diagnostic yield of small bowel series and enteroclysis have been disappointing being 0–5%[48,49] and 0–21% respectively.[17,50–52] These studies are particularly ineffective for detecting mucosal lesions such as angioectasias, which are the most common cause of small bowel bleeding.[3] Emerging diagnostic tools in OGIB are CT enterography and CT enteroclysis using newer multidetector CT systems. These offer an alternative means of detecting mass lesions as well as improved visualisation of small bowel mucosa including vascular lesions such as angioectasias, previously poorly seen using conventional radiographic studies.

The use of these radiological studies is generally not first line in the evaluation of obscure GI bleeding unless there is suspicion of bowel obstruction secondary to malignancy or Crohn's disease preventing the safe passage of a capsule endoscope.[9]

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