Unsuspected ileal stenosis causing obscure GI bleeding in patients with previous abdominal surgery--diagnosis by capsule endoscopy: a report of two cases
| Autor: | C. Abbiati, S. Zatelli, E. Contessini Avesani, G Gazzano, M. Gatti, A. Carnevali, M. Cappelletti, Maurizio Vecchi, Massimo Primignani, G. Beccari, R. De Franchis, Emanuele Rondonotti |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Capsules Constriction Pathologic Anastomosis Endoscopy Gastrointestinal law.invention Quadrant (abdomen) Capsule endoscopy law Salpingectomy Medicine Humans Hernia Ulcer Hepatology business.industry Ileal Diseases Anastomosis Surgical Gastroenterology Capsule Middle Aged medicine.disease Hernia Diaphragmatic Traumatic Surgery Stenosis Female business Gastrointestinal Hemorrhage Intestinal Obstruction Abdominal surgery |
| Zdroj: | Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. 35(8) |
| ISSN: | 1590-8658 |
| Popis: | Peri-anastomotic ulcerations may occur in patients with previous abdominal surgery. They may present only with obscure GI bleeding. We report two cases in whom capsule endoscopy identified postsurgical stenoses with ulcers as the cause of obscure GI bleeding. Case 1. A 57-year-old male operated on in 1970 for a post-traumatic diaphragm hernia followed by displacement of the caecum in the upper left abdominal quadrant. Case 2. A 32-year-old female with a salpingectomy for tuberculosis (1978) followed by segmental ileal resection for intestinal obstruction. Both patients had undergone extensive work-up including bidirectional endoscopies and enteroclysis with negative results. Capsule endoscopy with the GIVEN diagnostic system was done. Ileal stenoses with mucosal ulcers in dilated prestenotic loops were observed in both cases. The capsule was retained at the stenosis site, requiring ileal resection and anastomosis. Pathology reports showed mucosal ulcers. In case 2, tuberculosis was ruled out by tissue and faecal polymerase chain reaction and culture. Ileal stenoses with prestenotic ulcerations causing GI bleeding may occur in patients with previous abdominal surgery. Capsule endoscopy may clarify the diagnosis and shorten the diagnostic work-up. However, these patients should be warned that capsule retention requiring surgery might occur. |
| Databáze: | OpenAIRE |
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