Role of intraoperative enteroscopy in the management of gastrointestinal bleeding of small bowel origin

ABSTRACT

Through the period between June 1985 to January 1990, 28 patients were operated because of gastrointestinal bleeding of small bowel origin. The procedure of intraoperative enteroscopy was selected for 13 cases of this group of patients. Eight of whom were men. The indications for intraoperative enteroscopy were To detect otherwise occult lesions not evident by gross examination [seven cases], to confirm bleeding from known lesions [three cases], and to aid in determining the extend of necessary resection [three cases]. Enteroscopy was successfully performed in all cases either through per os route [five cases] or through small bowel enterotomy [eight cases]. Inspection of the small bowel through a small bowel enterotomy has a several advantages over per os and transanal routes. Bleeding was totally controlled in eleven patients during a mean follow up period of 12 months. Two patients died six months and one year after operation because of advanced neoplasia. No serious complications related directly to enteroscopy were encountered. Intraoperative enteroscopy is reliable, accurate and safe procedure. It is now an essential adjunct to laparotomy for gastrointestinal bleeding of small bowel origin