Endoscopy 2020; 52(S 01): S20
DOI: 10.1055/s-0040-1704068
ESGE Days 2020 oral presentations
Friday, April 24, 2020 08:30 – 10:30 Blood on the tracks Wicklow Meeting Room 3
© Georg Thieme Verlag KG Stuttgart · New York

RESULTS OF THE EVALUATION OF CLINICAL MANIFESTATION OF SMALL INTESTINE BLEEDING AND ITS SOURCES

E Ivanova
1   Medical Center Petrovskie Vorota, Endoscopy, Moscow, Russian Federation
2   Pirogov Russian National Research Medical University, Moscow, Russian Federation
,
E Tikhomirova
3   Pirogov Russian National Research Medical University, Moscow University Hospital 31, Medical Center “Klinika K+31”, Endoscopy, Moscow, Russian Federation
,
O Yudin
4   Medical Center K+31, Moscow, Russian Federation
,
S Larichev
5   Hospital 17, Moscow, Russian Federation,
,
A Budykina
6   Pirogov Russian National Research Medical University, Moscow University Hospital 31, Medical Center “Klinika K+31”, Moscow, Russian Federation
,
E Fedorov
7   Hospital № 31, Moscow, Russian Federation
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims To evaluate sources of intestinal bleeding and compare their clinical features.

Methods From 14.02.2007 to 10.03.2019 229 patients (m-117, f-112, mean age 52,3±18,3 years, range 17-89) were admitted to our clinics with GIB of unknown source. Obscure overt bleeding had 142 (62,0%) pts, obscure occult bleeding - 87 (38,0%) pts, associated with severe anemia in 86 (37,5%) pts, moderate anemia - in 87 (37,9%) pts and mild anemia - in 56 (24,4%) pts. Other complaints were: abdominal pain in 50 (51,0%) pts, diarrhea in 26 (26,5%) pts, nausea/vomiting in 22 (22,4%) pts. Videocapsule enteroscopy was performed in 179 (78,2%) pts, balloon-assisted enteroscopy - in 146 (63,7%) pts.

Results The source of GIB was found in 191 (83,4%) pts: small bowel (SB) - in 170 (89,0%) pts; upper/lower GI tract - in 21 (11,0%) pts, no pathology - in 38 (16,6%) pts. The sources of SB bleeding included vessel malformations (VM) in 65 (35,7%) pts, tumors - in 54 (29,7%) pts, erosive/ulcerative enteropathy - in 42 (23,1%) pts, diverticula - in 9 (5,3%) pts (incl. Meckel’s diverticulum (6)). VM were more common in patients older than 55 years, tumors and enteritis - up to 55 (p=0.03700). Pts with VM and tumors predominantly had obscure overt bleeding, pts with enteritis - obscure occult bleeding (p=0.03795). The period of tumors detection was longer year, than the diagnosis of enteritis (p=0.00648). Having tumors and enteritis patients more often experienced abdominal pain, that those with VM (p=0.00049); pts with enteritis more often complained of diarrhea than pts with VM and tumors (p=0.00001). All pts with SB diverticula had overt GIB, apparent with severe anemia, without any other complaints.

Conclusions The knowledge about different clinical manifestation of certain sources of intestinal bleeding may be useful in complex diagnostics.