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Obscure and occult gastrointestinal bleeding: comparison of different imaging modalities

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Abstract

Patients with persistent, recurrent, or intermittent bleeding from the gastrointestinal (GI) tract for which no definite cause has been identified by initial esophagogastroduodenoscopy, colonoscopy, or conventional radiologic evaluation are considered to have an obscure GI bleeding (OGIB). The diagnosis and management of patients with OGIB is challenging, often requiring extensive and expensive workups. The main objective is the identification of the etiology and site of bleeding, which should be as rapidly accomplished as possible, in order to establish the most appropriate therapy. The introduction of capsule endoscopy and double balloon enteroscopy and the recent improvements in CT and MRI techniques have revolutionized the approach to patients with OGIB, allowing the visualization of the entire GI tract, particularly the small bowel, until now considered as the “dark continent” . In this article we review and compare the radiologic and endoscopic examinations currently used in occult and OGIB, focusing on diagnostic patterns, pitfalls, strengths, weaknesses, and value in patients’ management.

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Authors and Affiliations

  1. Department of Neurosciences and Imaging, Section of Radiological Imaging, “G. d’Annunzio” University, via dei Vestini, 66013, Chieti, Italy

    Antonella Filippone, Roberta Cianci, Erika Pace & Antonio Raffaele Cotroneo

  2. Department of Medicine and Aging Sciences, Section of Internal Medicine and Gastroenterology and Center for Excellence on Ageing (Ce.S.I.), “G. d’Annunzio” University, via dei Vestini, 66013, Chieti, Italy

    Angelo Milano & Matteo Neri

Authors
  1. Antonella Filippone
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  2. Roberta Cianci
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  3. Angelo Milano
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  4. Erika Pace
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  5. Matteo Neri
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  6. Antonio Raffaele Cotroneo
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Correspondence to Antonella Filippone.

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Filippone, A., Cianci, R., Milano, A. et al. Obscure and occult gastrointestinal bleeding: comparison of different imaging modalities. Abdom Imaging 37, 41–52 (2012). https://doi.org/10.1007/s00261-011-9802-1

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