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Obscure gastrointestinal bleeding and small bowel pathology: comparison between wireless capsule endoscopy and multidetector-row CT enteroclysis

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Abstract

Obscure gastrointestinal bleeding is defined as bleeding of unknown origin, that persists or recurs after negative conventional barium contrast studies and upper and lower tract endoscopy. The causes of such a bleeding frequently arise in the small bowel, and they are represented by mucosal vascular abnormalities, neoplasms and other conditions such as Crohn’s disease, Meckel’s diverticulum, and vasculitis. Conventional barium contrast studies and push enteroscopy allow only a limited small bowel examination; moreover, intraoperative endoscopy may be inconclusive, since the small bowel is difficult to evaluate given its length and tortuous course. In the same way, angiographic diagnosis is stricktly related to the activity rate of hemorrhage. Wireless capsule endoscopy and multidetector-row CT enteroclysis are two recently developed minimally invasive techniques that may provide a complete small bowel examination, the first offering a direct visualization of the mucosal aspect, the second allowing evaluation of mural and extramural pathologies. This review is an update of the technique and clinical application of capsule endoscopy and multidetector-row CT enteroclysis in patients suffering from obscure small bowel bleeding.

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Authors and Affiliations

  1. Department of Clinical Sciences and Bioimages, Section of Radiological Sciences, “G. d’Annunzio” University of Chieti, Via dei Vestini, n.5, 66013, Chieti, Italy

    Antonella Filippone, Roberta Cianci, Sergio Valeriano, Veronica Di Mizio & Maria Luigia Storto

  2. Department of Medicine and Aging Sciences, Section of Internal Medicine and Gastroenterology, “G. d’Annunzio” University of Chieti, Via dei Vestini, n.5, 66013, Chieti, Italy

    Angelo Milano

Authors
  1. Antonella Filippone
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  2. Roberta Cianci
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  3. Angelo Milano
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  4. Sergio Valeriano
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  5. Veronica Di Mizio
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  6. Maria Luigia Storto
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Correspondence to Antonella Filippone.

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Filippone, A., Cianci, R., Milano, A. et al. Obscure gastrointestinal bleeding and small bowel pathology: comparison between wireless capsule endoscopy and multidetector-row CT enteroclysis. Abdom Imaging 33, 398–406 (2008). https://doi.org/10.1007/s00261-007-9271-8

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