Endoscopic diagnosis of gastrointestinal bleeding of unknown origin

In recent years push enteroscopy has become the most important method in the examination of patients with obscure gastrointestinal bleeding. We summarise our experiences with 148 enteroscopies performed on 140 patients with bleeding of unknown origin. The source of bleeding could be identified in 81 patients (57.86%). The most common lesions were small bowel tumors (13.57%) and vascular malformations (12.86%). Several patients (22.86%) referred for enteroscopy had lesions in the esophagus, stomach and proximal duodenum that were missed at upper endoscopy. The authors conclude that push enteroscopy has a major role in the evaluation of patients with obscure gastrointestinal bleeding. Enteroscopy should be the first diagnostic step after negative esophago-gastroduodenoscopy and negative colonoscopy. Enteroscopy seems to be superior to other diagnostic methods. It is well tolerable and is not time consuming.