GASTROENTEROLOGY ARTICLE OF THE WEEK
October 13, 2010
ASGE. The role of endoscopy in the management of obscure GI Bleeding. Gastrointest Endosc 2010;72:471-479
1. A 59 y/o male is referred to you for recurrent melena and iron deficiency anemia. The referring gastroenterologist performed an EGD and a colonoscopy with no diangnostic findings. The patient is otherwise asymptomatic. Your first procedure to evaluate this patient should be:
a. Capsule endoscopy
b. Spiral endoscopy
c. Repeat EGD and Colonoscopy
d. Nuclear medicine bleeding scan
True or False
2. The yield of small bowel follow-through or enterocylsis X-rays for occult bleeding is <10%
3. Push enteroscopy do not result in decreased transfusion needs or improvement in functional status of the patient
4. Biopsies of the small bowel should be considered in patients with iron deficiency anemia
5. The diagnostic yield of antegrade balloon enteroscopy is higher to capsule endoscopy
6. Tumors of the small bowel are the most common etiology of OGIB in people <50 years of age
7. Stable patients with occult bleeding, negative EGD, colonoscopy and capsule endoscopy should be observed on iron therapy if iron deficiency is present, prior to more invasive testing.
8. For patients with occult GI Bleeding persisting after a negative capsule endoscopy, a repeat capsule endoscopy study usually yields the diagnosis in 85% of patients