Endoscopic Treatment of Small Bowel Bleeding

Gastrointest Endosc Clin N Am. 2024 Apr;34(2):331-343. doi: 10.1016/j.giec.2023.09.007. Epub 2023 Sep 27.

Abstract

Approximately 5% of all gastrointestinal (GI) bleeding originates from the small bowel. Endoscopic therapy of small bowel bleeding should only be undertaken after consideration of the different options, and the risks, benefits, and alternatives of each option. Endoscopic therapy options for small bowel bleeding are like those treatments used for other forms of bleeding in the upper and lower GI tract. Available endoscopic treatment options include thermal therapy (eg, argon plasma coagulation and bipolar cautery), mechanical therapy (eg, hemoclips), and medical therapy (eg, diluted epinephrine injection). Patients with complicated comorbidities would benefit from evaluation and planning of available treatment options, including conservative and/or medical treatments, beyond endoscopic therapy.

Keywords: Angioectasias; Device-assisted enteroscopy; Dieulafoy lesions; Endoscopic therapy; Push enteroscopy; Small bowel bleeding; Small bowel capsule endoscopy.

Publication types

  • Review

MeSH terms

  • Capsule Endoscopy*
  • Endoscopy, Gastrointestinal* / adverse effects
  • Epinephrine / therapeutic use
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / surgery
  • Humans
  • Intestine, Small / surgery

Substances

  • Epinephrine