Small Bowel Sources of Gastrointestinal Bleeds

  • Shuyan Wei
  • Lillian S. Kao


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.


Small bowel gastrointestinal bleed Vascular ectasia Dieulafoy’s lesion Meckel’s diverticulum Video capsule endoscopy (VCE) Angiography Enteroscopy 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgeryMcGovern Medical School at the University of Texas Health Science Center at HoustonHoustonUSA

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