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Lewis BS (1994)
Small intestinal bleedingGastroenterol Clin North Am, 23
Cave DR Hoffman JS (1994)
Intra-operative enteroscopy with a Sonde intestinal fiberscopeGastrointest Endosc, 40
Brandt L Frank M (1981)
latric submucosal hemorrhage: a pitfall of intraoperative endoscopyAm J Gastroenterol, 75
Benacci JC Ress AM (1992)
Efficacy of intraoperative enteroscopy in diagnosis and prevention of recurrent, occult gastrointestinal bleedingAm J Surg, 163
Romeu J Messer J (1984)
The value of proximal jejunoscopy in unexplained gastrointestinal bleedingGastrointest Endosc, 30
Stanforth C Flickinger E (1989)
Intraoperative video panendoscopy for diagnosing sites of chronic intestinal bleedingAm J Surg, 157
Tytgat G Mathus-Vliegen E (1986)
Intraoperative endoscopy: technique, indications and resultsGastrointest Endosc, 32
Wenger J Lewis B (1995)
Intraoperative enteroscopy versus small bowel enteroscopy in patients with obscure GI bleedingAm J Gastroenterol, 86
Christensen M Richter J (1989)
Angiodysplasia: natural history and efficacy of therapeutic interventionsDig Dis Sci, 34
Vargish T Apelgren K (1988)
Principles for use of intraoperative enteroscopy for hemorrhage from the small bowelAm Surg, 54
Mauer K Berner JS (1994)
Push and Sonde enteroscopy for the diagnosis of obscure gastrointestinal bleedingAm J Gastroenterol, 89
Ohri S Desa L (1991)
Role of intraoperative enteroscopy in obscure gastrointestinal bleeding of small bowel originBr J Surg, 78
Tagle M Chong J (1994)
Small bowel push-type fiberoptic enteroscopy for patients with occult gastrointestinal bleeding or suspected small bowel pathologyAm J Gastroenterol, 89
Katz LB Szold A (1992)
Surgical approach to occult gastrointestinal bleedingAm J Surg, 163
Bombeck CT (1975)
Intraoperative esophagoscopy, gastroscopy, colonoscopy, and endoscopy of the small bowelSurg Clin North Am, 55
Waye J Lewis B (1988)
Small bowel enteroscopy: a comparison of findings with push and Sonde enteroscopy in 81 patients with Gl bleeding of obscure originGastrointest Endosc, 34
Eckhauser F Strodel W (1984)
Intraoperative fiberoptic endoscopyAm Surg, 50
Waye JD Lewis BS (1988)
Chronic gastrointestinal bleeding of obscure origin: role of small bowel enteroscopyGastroenterology, 94
Gostout CJ (1993)
Improving the withdrawal phase of Sonde enteroscopy with the 'push-away' methodGastrointest Endosc, 39
Bowden T (1989)
Endoscopy of the small intestineSurg Clin North Am, 19
Laine L Yang R (1995)
Mucosal stripping: a complication of push enteroscopyGastrointest Endosc, 4
Sawyer R Foutch PG (1990)
Push-enteroscopy for diagnosis of patients with gastrointestinal bleeding of obscure originGastrointest Endosc, 36
Wong S Lau W (1989)
Intraoperative enteroscopy for bleeding angiodysplasias of the small intestineSurg Gynecol Obstet, 168
Killian SE Dykman DD (1993)
Initial experience with the Pentax VSBOP2900 enteroscopeAm J Gastroenterol, 88
Yuen WK Lau WY (1992)
Obscure bleeding in the gastrointestinal tract originating in the small intestineSurg Gynecol Obstet, 174
Abstract Objective: To review our experience with intraoperative small-bowel Sonde enteroscopy in evaluating occult bleeding in the small intestine. Design: Retrospective study with 100% follow-up. Setting: University-affiliated, tertiary-care teaching hospital. Patients: Sixteen consecutive patients referred with occult gastrointestinal bleeding in whom esophagogastroduodenoscopy, push enteroscopy, and colonoscopy had failed to identify the source of bleeding. Fourteen of the 16 patients had required one or more transfusions. Main Outcome Measures: Completeness of visualization, diagnostic accuracy, and complications of the procedure and follow-up for recurrent bleeding. Results: In all 16 patients, intraoperative Sonde enteroscopy allowed visualization of the entire small bowel. In 14 of the 16, it revealed the cause of bleeding, which was ileal angiodysplasia in three patients, ileal ulcers in six patients, neoplasia in two patients, and ileal ulcers caused by Crohn's disease, small-intestinal enteropathy and varices caused by portal hypertension, and radiotion stricture in one patient each. Two patients had normal small-bowel mucosa. The patients with mucosal disease underwent small-bowel resection or oversewing of bleeding sites. Two surgical complications occurred: prolonged postoperative ileus (one patient) and small-bowel obstruction that resolved without surgery (one patient). Two of the patients with angiodysplasia had recurrent bleeding postoperatively. Conclusions: Intraoperative Sonde enteroscopy is safe and effective in localizing small-intestinal bleeding sites, providing complete visualization of the small-bowel mucosa without enterotomy while avoiding the trauma that can be caused by push endoscopy. It is the diagnostic assessment of choice in selected patients with occult gastrointestinal bleeding of presumed small-bowel origin.(Arch Surg. 1996;131:272-277) References 1. Szold A, Katz LB, Lewis BS. Surgical approach to occult gastrointestinal bleeding . Am J Surg . 1992;163:90-93.Crossref 2. Lewis BS. Small intestinal bleeding . Gastroenterol Clin North Am . 1994;23:6791. 3. Dykman DD, Killian SE. Initial experience with the Pentax VSBOP2900 enteroscope . Am J Gastroenterol . 1993:88:570-573. 4. Berner JS, Mauer K, Lewis B. Push and Sonde enteroscopy for the diagnosis of obscure gastrointestinal bleeding . Am J Gastroenterol . 1994;89:2139-2142. 5. Foutch PG, Sawyer R, Sanowski R. Push-enteroscopy for diagnosis of patients with gastrointestinal bleeding of obscure origin . Gastrointest Endosc . 1990;36:337-341.Crossref 6. Lewis B, Waye J. Small bowel enteroscopy: a comparison of findings with push and Sonde enteroscopy in 81 patients with Gl bleeding of obscure origin . 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Intraoperative video panendoscopy for diagnosing sites of chronic intestinal bleeding . Am J Surg . 1989;157:137-144.Crossref 14. Frank M, Brandt L, Boley S. latric submucosal hemorrhage: a pitfall of intraoperative endoscopy . Am J Gastroenterol . 1981;75:209-210. 15. Lau W, Wong S, Yuen W, et al. Intraoperative enteroscopy for bleeding angiodysplasias of the small intestine . Surg Gynecol Obstet . 1989;168:341-344. 16. Mathus-Vliegen E, Tytgat G. Intraoperative endoscopy: technique, indications and results . Gastrointest Endosc . 1986;32:381-384.Crossref 17. Strodel W, Eckhauser F, Knol J, et al. Intraoperative fiberoptic endoscopy . Am Surg . 1984;50:340-344. 18. Lewis B, Wenger J, Waye J. Intraoperative enteroscopy versus small bowel enteroscopy in patients with obscure GI bleeding . Am J Gastroenterol . 1995; 86:171-174. 19. Ress AM, Benacci JC, Sarr MG. Efficacy of intraoperative enteroscopy in diagnosis and prevention of recurrent, occult gastrointestinal bleeding . Am J Surg . 1992;163:94-99.Crossref 20. Lau WY, Yuen WK, Chu KW, Poon GP, Li AKC. Obscure bleeding in the gastrointestinal tract originating in the small intestine . Surg Gynecol Obstet . 1992: 174:119-124. 21. Hoffman JS, Cave DR, Birkett D. Intra-operative enteroscopy with a Sonde intestinal fiberscope . Gastrointest Endosc . 1994;40:229-230.Crossref 22. Gostout CJ. Improving the withdrawal phase of Sonde enteroscopy with the 'push-away' method . Gastrointest Endosc . 1993;39:69-72.Crossref 23. Chong J, Tagle M, Barkin JS, Reiner DK. Small bowel push-type fiberoptic enteroscopy for patients with occult gastrointestinal bleeding or suspected small bowel pathology . Am J Gastroenterol . 1994;89:2143-2146. 24. Yang R, Laine L. Mucosal stripping: a complication of push enteroscopy . Gastrointest Endosc . 1995;4:156-158.Crossref 25. Richter J, Christensen M, Colditz G. Angiodysplasia: natural history and efficacy of therapeutic interventions . Dig Dis Sci . 1989;34:1542-1546.Crossref
Archives of Surgery – American Medical Association
Published: Mar 1, 1996
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