Loading...
Patients with severe persistent obscure or overt gastrointestinal bleeding and negative endoscopic evaluations create a diagnostic challenge. One suggested approach is to perform small bowel endoscopy after provoking bleeding with an anticoagulant or antiplatelet drug to identify the source.
To test this strategy, investigators at a single center retrospectively reviewed records of 27 patients who underwent 38 bleeding-provocation procedures. All patients had transfusion-dependent iron-deficiency anemia and persistent bleeding. Endoscopy was performed using video capsule endoscopy or double-balloon enteroscopy.
The provocation procedures were classified into three groups:
13 were performed on treatment-experienced patients, who had previous bl…