Guideline
The role of endoscopy in the management of suspected small-bowel bleeding

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Evaluation and management of patients with small-bowel bleeding

The evaluation and management of patients with small-bowel bleeding depends on clinical factors, such as the age of the patient, quality of the prior endoscopic evaluation, and the overt or occult status of the bleeding. Clinical signs, such as the nature of the bleeding (eg, melena vs hematochezia), can help direct the choice of endoscopic tests. In addition, local availability of procedures, patient preferences, physician expertise, risks, and costs are also important determinants of

Disclosures

R. Muthusamy is a consultant for Boston Scientific and received research support from Covidien GI Solutions. M. Khashab is a consultant for Boston Scientific. All other authors disclosed no financial relationships relevant to this publication.

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      Citation Excerpt :

      EGD should be performed before small bowel evaluation early in an acute presentation of GI bleeding (within 24 hours) when overt and occult UGI bleeding is suspected.10 However, if recent EGD has been completed, an EGD with push enteroscopy to evaluate for proximal small bowel lesions is recommended if readily available9; however, some facilities may not have access to equipment using this technique. Prior literature demonstrates substantial missed bleeding sources within reach of conventional upper and lower endoscopy, if not attempted.11,12

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    This document was reviewed and approved by the Governing Board of the American Society for Gastrointestinal Endoscopy.

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