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Does Intraoperative Endoscopy Still Apply in Obscure Gastrointestinal Bleeding Treatment? A Case Report and a Literature Review with a Diagnostic Algorithm Proposal

Abstract

Tomasz Guzel, Emilia Kowalczyk, Wojciech Korcz, Jan Pertkiewicz, Michał Mazurkiewicz, Włodzimierz Cebulski and Maciej Słodkowski

Background: Obscure gastrointestinal bleeding seems to be important problem affecting increasing group of patients. Due to its localization and mild symptoms investigation is difficult and usually requires advanced procedures. Unfortunately, it is often impossible to show precisely a source of bleeding what delays treatment and can cause severe bleeding. Methods: We describe a case report of the patient who refused surgical treatment despite proper bleeding localization by enteral capsule what caused serious bleeding few months later. Patient was operated on duty intraoperative endoscopy was necessary to perform. After treatment he left hospital in a good condition without any negative consequences. Discussion: Authors discussed investigation methods, a role of endoscopy performed intraoperatively and propose a scheme helpful during obscure bleeding investigation.

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