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Hard or recurrent gastrointestinal bleeding: Etiology and diagnostic pitfalls

par Van Gossum, Marc ;De Reuck, Marc ;Nyst, Jean-François ;Ramdani, Brahim;Deltenre, Michel Arthur
Référence Acta endoscopica, 18, 4, page (231-239)
Publication Publié, 1988

Article révisé par les pairs

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Résumé :

We retrospectively investigated digestive bleeding of obscure origin, selecting patients where at the first gastroscopy and sigmoidoscopy the definitive diagnosis was not made. We identified three clinical situations: [1] cataclysmatic upper digestive bleeding with major hemodynamic consequences; [2] upper digestive bleeding with presence of blood in the stomach without any identified focal lesion. Submucosal non erosive hemorrhagic gastritis, secondary to venous malformations or ischaemic lesions, is the most significant etiological finding; [3] recurrent digestive bleeding without blood in the stomach may be of gastric, intestinal, or colonic origin. The diagnosis of gastric lesions necessitates repeated emergency gastroscopy with stimulation of the gastric mucosa. Laparotomy identifies half of the small intestinal lesions. Pancolonoscopy identifies angiodysplastic colonic lesions.