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Small Bowel Sources of Gastrointestinal Bleeds

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Emergency General Surgery

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Abstract

Small bowel gastrointestinal (GI) bleeding accounts for 5–10% of all GI bleeds. Common causes in adults include vascular ectasias, neoplasms, ulcers caused by nonsteroidal anti-inflammatory drugs (NSAIDs), Crohn’s disease, Dieulafoy’s lesions, and Meckel’s diverticula. Diagnostic tools to evaluate patients with suspected small bowel GI bleeds include video capsule endoscopy, computed tomographic enterography and magnetic resonance enterography, nuclear medicine scans, angiography, and enteroscopy. Treatments vary depending on the source of bleeding, ongoing blood loss, and hemodynamic status. Hemodynamically unstable patients with acute bleeding should undergo conventional angiography. Surgical treatment requires guidance from preoperative source localization and is often used as last resort. Endoscopic therapies include sclerotherapy, coagulation, clipping, and band ligation of bleeding lesions. Medical management of small bowel GI bleeds is focused on treatment of anemia and reducing the risk of recurrent bleeding.

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Authors and Affiliations

  1. Department of Surgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA

    Shuyan Wei & Lillian S. Kao

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  1. Shuyan Wei
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  2. Lillian S. Kao
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Correspondence to Lillian S. Kao .

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Editors and Affiliations

  1. Dell Medical School, University of Texas at Austin, Austin, TX, USA

    Carlos V. R. Brown

  2. Trauma and Surgical Critical Care, University of Southern California, Los Angeles, CA, USA

    Kenji Inaba

  3. Madigan Army Medical Center, Tacoma, WA, USA

    Matthew J. Martin

  4. Brigham and Womens’s Hospital, Harvard Medical School, Boston, MA, USA

    Ali Salim

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Wei, S., Kao, L.S. (2019). Small Bowel Sources of Gastrointestinal Bleeds. In: Brown, C., Inaba, K., Martin, M., Salim, A. (eds) Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-96286-3_19

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  • DOI: https://doi.org/10.1007/978-3-319-96286-3_19

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