Bleeding Lesion of the Small Bowel: an Extensive Update Leaving No Stone Unturned
Purpose of Review Gastrointestinal bleeding originating from the small bowel (SB) poses a challenge to the treating gastroenterologist. Once diagnosed, management is not a walk in the park either. This review intends to summarize the current state-of-the-art evidence in a complete way with special a...
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| Veröffentlicht in: | Current gastroenterology reports 2018-02, Vol.20 (2), p.5-5, Article 5 |
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| creator | Van de Bruaene, Cedric Hindryckx, Pieter Van de Bruaene, Laurens De Looze, Danny |
| description | Purpose of Review
Gastrointestinal bleeding originating from the small bowel (SB) poses a challenge to the treating gastroenterologist. Once diagnosed, management is not a walk in the park either. This review intends to summarize the current state-of-the-art evidence in a complete way with special attention for vascular and ulcerative lesions, to provide the reader with a clinical guide and flow chart towards SB bleeding.
Recent Findings
Absence of SB bleeding lesions on CE does not directly yield better prognosis; although having a lower rebleeding rate the first 2 years, rebleeding in the long term is high. Push enteroscopy can play an early role in patients with SB bleeding if suspicion of angioectasia is high, since these lesions tend to be located in the proximal SB. Endoscopic management of angioectasia is, however, difficult and shows poor results.
Summary
Capsule endoscopy (CE) or device-assisted enteroscopy (DAE) remain the diagnostic mainstay in SB bleeding, choosing one over the other based upon patient characteristics and expected lesions. |
| doi_str_mv | 10.1007/s11894-018-0610-4 |
| format | Article |
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Gastrointestinal bleeding originating from the small bowel (SB) poses a challenge to the treating gastroenterologist. Once diagnosed, management is not a walk in the park either. This review intends to summarize the current state-of-the-art evidence in a complete way with special attention for vascular and ulcerative lesions, to provide the reader with a clinical guide and flow chart towards SB bleeding.
Recent Findings
Absence of SB bleeding lesions on CE does not directly yield better prognosis; although having a lower rebleeding rate the first 2 years, rebleeding in the long term is high. Push enteroscopy can play an early role in patients with SB bleeding if suspicion of angioectasia is high, since these lesions tend to be located in the proximal SB. Endoscopic management of angioectasia is, however, difficult and shows poor results.
Summary
Capsule endoscopy (CE) or device-assisted enteroscopy (DAE) remain the diagnostic mainstay in SB bleeding, choosing one over the other based upon patient characteristics and expected lesions.</description><identifier>ISSN: 1522-8037</identifier><identifier>EISSN: 1534-312X</identifier><identifier>DOI: 10.1007/s11894-018-0610-4</identifier><identifier>PMID: 29516183</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Age ; Anti-inflammatory agents ; Anticoagulants ; Blood diseases ; Colonoscopy ; Drug dosages ; Endoscopy ; Etiology ; Gastroenterology ; Hemodialysis ; Hemoglobin ; Hypertension ; Inflammatory bowel disease ; Kidney diseases ; Liver cirrhosis ; Medicine ; Medicine & Public Health ; Multivariate analysis ; Nonsteroidal anti-inflammatory drugs ; Patients ; Risk factors ; Section Editor ; Small Intestine (D Sachar ; Topical Collection on Small Intestine ; Ulcers</subject><ispartof>Current gastroenterology reports, 2018-02, Vol.20 (2), p.5-5, Article 5</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2874-209d431f85cda92abcef576d28aa9fb84b4c60fd23d0a30e5f62841daa161c103</citedby><cites>FETCH-LOGICAL-c2874-209d431f85cda92abcef576d28aa9fb84b4c60fd23d0a30e5f62841daa161c103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11894-018-0610-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2918765516?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,777,781,21369,21370,27905,27906,33511,33512,33725,33726,41469,42538,43640,43786,51300,64364,64366,64368,72218</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29516183$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Van de Bruaene, Cedric</creatorcontrib><creatorcontrib>Hindryckx, Pieter</creatorcontrib><creatorcontrib>Van de Bruaene, Laurens</creatorcontrib><creatorcontrib>De Looze, Danny</creatorcontrib><title>Bleeding Lesion of the Small Bowel: an Extensive Update Leaving No Stone Unturned</title><title>Current gastroenterology reports</title><addtitle>Curr Gastroenterol Rep</addtitle><addtitle>Curr Gastroenterol Rep</addtitle><description>Purpose of Review
Gastrointestinal bleeding originating from the small bowel (SB) poses a challenge to the treating gastroenterologist. Once diagnosed, management is not a walk in the park either. This review intends to summarize the current state-of-the-art evidence in a complete way with special attention for vascular and ulcerative lesions, to provide the reader with a clinical guide and flow chart towards SB bleeding.
Recent Findings
Absence of SB bleeding lesions on CE does not directly yield better prognosis; although having a lower rebleeding rate the first 2 years, rebleeding in the long term is high. Push enteroscopy can play an early role in patients with SB bleeding if suspicion of angioectasia is high, since these lesions tend to be located in the proximal SB. Endoscopic management of angioectasia is, however, difficult and shows poor results.
Summary
Capsule endoscopy (CE) or device-assisted enteroscopy (DAE) remain the diagnostic mainstay in SB bleeding, choosing one over the other based upon patient characteristics and expected lesions.</description><subject>Age</subject><subject>Anti-inflammatory agents</subject><subject>Anticoagulants</subject><subject>Blood diseases</subject><subject>Colonoscopy</subject><subject>Drug dosages</subject><subject>Endoscopy</subject><subject>Etiology</subject><subject>Gastroenterology</subject><subject>Hemodialysis</subject><subject>Hemoglobin</subject><subject>Hypertension</subject><subject>Inflammatory bowel disease</subject><subject>Kidney diseases</subject><subject>Liver cirrhosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multivariate analysis</subject><subject>Nonsteroidal anti-inflammatory drugs</subject><subject>Patients</subject><subject>Risk factors</subject><subject>Section Editor</subject><subject>Small Intestine (D Sachar</subject><subject>Topical Collection on Small Intestine</subject><subject>Ulcers</subject><issn>1522-8037</issn><issn>1534-312X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kMtKAzEUhoMo1tsDuJGAGzejOZlMJuPOlnqBokgV3IV0ckanTJM6mVZ9e1PqBQRXCcn3n_PzEXII7BQYy88CgCpEwkAlTAJLxAbZgSwVSQr8aXN15zxRLM17ZDeEKWM8puQ26fEiAwkq3SH3_QbR1u6ZjjDU3lFf0e4F6Xhmmob2_Rs259Q4Onzv0IV6ifRxbk2HETfLVezW03HnXXx33aJ1aPfJVmWagAdf5x55vBw-DK6T0d3VzeBilJRc5SLhrLAihUplpTUFN5MSqyyXlitjimqixESUklWWp5aZlGFWSa4EWGNi8xJYukdO1nPnrX9dYOj0rA4lNo1x6BdBcwYcQBRSRvT4Dzr1sWtsp3kBKpdZ1BEpWFNl60NosdLztp6Z9kMD0yvfeu1bR9965VuLmDn6mryYzND-JL4FR4CvgRC_3DO2v6v_n_oJvFCI-Q</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Van de Bruaene, Cedric</creator><creator>Hindryckx, Pieter</creator><creator>Van de Bruaene, Laurens</creator><creator>De Looze, Danny</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20180201</creationdate><title>Bleeding Lesion of the Small Bowel: an Extensive Update Leaving No Stone Unturned</title><author>Van de Bruaene, Cedric ; Hindryckx, Pieter ; Van de Bruaene, Laurens ; De Looze, Danny</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2874-209d431f85cda92abcef576d28aa9fb84b4c60fd23d0a30e5f62841daa161c103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age</topic><topic>Anti-inflammatory agents</topic><topic>Anticoagulants</topic><topic>Blood diseases</topic><topic>Colonoscopy</topic><topic>Drug dosages</topic><topic>Endoscopy</topic><topic>Etiology</topic><topic>Gastroenterology</topic><topic>Hemodialysis</topic><topic>Hemoglobin</topic><topic>Hypertension</topic><topic>Inflammatory bowel disease</topic><topic>Kidney diseases</topic><topic>Liver cirrhosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multivariate analysis</topic><topic>Nonsteroidal anti-inflammatory drugs</topic><topic>Patients</topic><topic>Risk factors</topic><topic>Section Editor</topic><topic>Small Intestine (D Sachar</topic><topic>Topical Collection on Small Intestine</topic><topic>Ulcers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Van de Bruaene, Cedric</creatorcontrib><creatorcontrib>Hindryckx, Pieter</creatorcontrib><creatorcontrib>Van de Bruaene, Laurens</creatorcontrib><creatorcontrib>De Looze, Danny</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Current gastroenterology reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Van de Bruaene, Cedric</au><au>Hindryckx, Pieter</au><au>Van de Bruaene, Laurens</au><au>De Looze, Danny</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bleeding Lesion of the Small Bowel: an Extensive Update Leaving No Stone Unturned</atitle><jtitle>Current gastroenterology reports</jtitle><stitle>Curr Gastroenterol Rep</stitle><addtitle>Curr Gastroenterol Rep</addtitle><date>2018-02-01</date><risdate>2018</risdate><volume>20</volume><issue>2</issue><spage>5</spage><epage>5</epage><pages>5-5</pages><artnum>5</artnum><issn>1522-8037</issn><eissn>1534-312X</eissn><abstract>Purpose of Review
Gastrointestinal bleeding originating from the small bowel (SB) poses a challenge to the treating gastroenterologist. Once diagnosed, management is not a walk in the park either. This review intends to summarize the current state-of-the-art evidence in a complete way with special attention for vascular and ulcerative lesions, to provide the reader with a clinical guide and flow chart towards SB bleeding.
Recent Findings
Absence of SB bleeding lesions on CE does not directly yield better prognosis; although having a lower rebleeding rate the first 2 years, rebleeding in the long term is high. Push enteroscopy can play an early role in patients with SB bleeding if suspicion of angioectasia is high, since these lesions tend to be located in the proximal SB. Endoscopic management of angioectasia is, however, difficult and shows poor results.
Summary
Capsule endoscopy (CE) or device-assisted enteroscopy (DAE) remain the diagnostic mainstay in SB bleeding, choosing one over the other based upon patient characteristics and expected lesions.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29516183</pmid><doi>10.1007/s11894-018-0610-4</doi><tpages>1</tpages></addata></record> |
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| subjects | Age Anti-inflammatory agents Anticoagulants Blood diseases Colonoscopy Drug dosages Endoscopy Etiology Gastroenterology Hemodialysis Hemoglobin Hypertension Inflammatory bowel disease Kidney diseases Liver cirrhosis Medicine Medicine & Public Health Multivariate analysis Nonsteroidal anti-inflammatory drugs Patients Risk factors Section Editor Small Intestine (D Sachar Topical Collection on Small Intestine Ulcers |
| title | Bleeding Lesion of the Small Bowel: an Extensive Update Leaving No Stone Unturned |
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