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. 1984 Jun 2;288(6431):1663–1665. doi: 10.1136/bmj.288.6431.1663

Obscure gastrointestinal haemorrhage of small-bowel origin.

J N Thompson, A P Hemingway, G A McPherson, H C Rees, D J Allison, J Spencer
PMCID: PMC1441504  PMID: 6426683

Abstract

The records of 37 patients investigated for obscure gastrointestinal haemorrhage originating from the small bowel were reviewed retrospectively. Bleeding was caused by Meckel's diverticula in eight cases, smooth muscle tumours in seven cases, vascular anomalies in 14 cases, and other single lesions in eight cases. The lesions were identified by angiography in 18 patients, operation in 17, and barium follow through examination in two. Only one patient under 50 years of age had a lesion that would not have been found by careful laparotomy. Early laparotomy is advisable in patients aged under 50 with obscure gastrointestinal bleeding; expert selective angiography is recommended before operation in patients aged over 50 and those who have already undergone a laparotomy yielding negative results.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allison D. J., Hemingway A. P. Angiodysplasia: does old age begin at nineteen? Lancet. 1981 Oct 31;2(8253):979–980. doi: 10.1016/s0140-6736(81)91169-7. [DOI] [PubMed] [Google Scholar]
  2. Allison D. J., Hemingway A. P., Cunningham D. A. Angiography in gastrointestinal bleeding. Lancet. 1982 Jul 3;2(8288):30–33. doi: 10.1016/s0140-6736(82)91162-x. [DOI] [PubMed] [Google Scholar]
  3. Athanasoulis C. A., Moncure A. C., Greenfield A. J., Ryan J. A., Dodson T. F. Intraoperative localization of small bowel bleeding sites with combined use of angiographic methods and methylene blue injection. Surgery. 1980 Jan;87(1):77–84. [PubMed] [Google Scholar]
  4. Bartram C. I., Amess J. A. The diagnosis of Meckel's diverticulum by small bowel enema in the investigation of obscure intestinal bleeding. Br J Surg. 1980 Jun;67(6):417–418. doi: 10.1002/bjs.1800670611. [DOI] [PubMed] [Google Scholar]
  5. Baum S. Angiography and the gastrointestinal bleeder. Radiology. 1982 May;143(2):569–572. doi: 10.1148/radiology.143.2.6978502. [DOI] [PubMed] [Google Scholar]
  6. Boley S. J., Brandt L. J. Colonic ectasias and lower intestinal bleeding. Hosp Pract (Hosp Ed) 1982 May;17(5):137–144. doi: 10.1080/21548331.1982.11702314. [DOI] [PubMed] [Google Scholar]
  7. Fazio V. W., Zelas P., Weakley F. L. Intraoperative angiography and the localization of bleeding from the small intestine. Surg Gynecol Obstet. 1980 Nov;151(5):637–640. [PubMed] [Google Scholar]
  8. Hemingway A. P., Allison D. J. Angiodysplasia and Meckel's diverticulum: a congenital association? Br J Surg. 1982 Aug;69(8):493–496. doi: 10.1002/bjs.1800690822. [DOI] [PubMed] [Google Scholar]
  9. Heyman S., Sacks B., Khettry J., Steer M. L. Localization of bleeding small intestinal lesions using scanning techniques. Surgery. 1979 Apr;85(4):372–376. [PubMed] [Google Scholar]
  10. Hines J. R., Stryker S. J., Neiman H. L., Larsen L. R., Gottlieb J., Craig R. M., Poticha S. M. Intraoperative angiography in intestinal angiodysplasia. Surg Gynecol Obstet. 1981 Apr;152(4):453–460. [PubMed] [Google Scholar]
  11. OLSON J. D., DOCKERTY M. B., GRAY H. K. Benign tumors of the small bowel. Ann Surg. 1951 Aug;134(2):195–204. doi: 10.1097/00000658-195108000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Peoples J. B., Kartha R., Sharif S. Multiple phlebectasia of the small intestine. Am Surg. 1981 Aug;47(8):373–376. [PubMed] [Google Scholar]
  13. Petrokubi R. J., Baum S., Rohrer G. V. Cimetidine administration resulting in improved pertechnetate imaging of Meckel's diverticulum. Clin Nucl Med. 1978 Oct;3(10):385–388. doi: 10.1097/00003072-197810000-00004. [DOI] [PubMed] [Google Scholar]
  14. RIVER L., SILVERSTEIN J., TOPE J. W. Benign neoplasms of the small intestine; a critical comprehensive review with reports of 20 new cases. Surg Gynecol Obstet. 1956 Jan;102(1):1–38. [PubMed] [Google Scholar]
  15. SHEPHERD J. A. Angiomatous conditions of the gastro-intestinal tract. Br J Surg. 1953 Mar;40(163):409–421. doi: 10.1002/bjs.18004016302. [DOI] [PubMed] [Google Scholar]
  16. Spechler S. J., Schimmel E. M. Gastrointestinal tract bleeding of unknown origin. Arch Intern Med. 1982 Feb;142(2):236–240. [PubMed] [Google Scholar]
  17. Spiller R. C., Parkins R. A. Recurrent gastrointestinal bleeding of obscure origin: report of 17 cases and a guide to logical management. Br J Surg. 1983 Aug;70(8):489–493. doi: 10.1002/bjs.1800700812. [DOI] [PubMed] [Google Scholar]
  18. Treves S., Grand R. J., Eraklis A. J. Pentagastrin stimulation of technetium-99m uptake by ectopic gastric muscosa in a Meckel's diverticulum. Radiology. 1978 Sep;128(3):711–712. doi: 10.1148/128.3.711. [DOI] [PubMed] [Google Scholar]
  19. Williams R. S. Management of Meckel's diverticulum. Br J Surg. 1981 Jul;68(7):477–480. doi: 10.1002/bjs.1800680712. [DOI] [PubMed] [Google Scholar]

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