Endoscopy 2002; 34(7): 588-590
DOI: 10.1055/s-2002-33209
Case Report
© Georg Thieme Verlag Stuttgart · New York

Wireless Capsule Endoscopy in a Patient with Obscure Occult Bleeding

M.  Hahne1 , H.  E.  Adamek1 , D.  Schilling1 , J.  F.  Riemann1
  • 1Dept. of Gastroenterology, Ludwigshafen Hospital (Academic Hospital of the University of Mainz), Ludwigshafen, Germany
Further Information

Publication History

Submitted 16 October 2001

Accepted after Revision 22 January 2002

Publication Date:
12 August 2002 (online)

A case of obscure/occult bleeding in a 39-year old man with a 7-year history of chronic fatigue and iron-deficiency anemia is presented here. Esophagogastroduodenoscopy, push enteroscopy, ileocolonoscopies, and a magnetic resonance imaging small-bowel follow-through did not reveal any abnormalities. Multiple inflammatory lesions with fibrin-covered ulcers and petechial bleeding in the area of the lower jejunum and ileum were diagnosed only with capsule endoscopy. One ulcer located near the ileocecal valve was then biopsied during a repeat ileocolonoscopy, and the histology showed signs of Crohn's enteritis. The further treatment approach was changed, with medical treatment being initiated and intraoperative enteroscopy being averted. Wireless capsule endoscopy clarified the cause of the obscure/occult bleeding in this patient and contributed to the diagnosis and endoscopic imaging of an isolated Crohn's enteritis, which is the cause of bleeding in approximately 10 - 20 % of cases of occult bleeding.

References

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J. F. Riemann, M.D.

Dept. of Internal Medicine C · Ludwigshafen Hospital

Bremserstrasse 79 · 67063 Ludwigshafen · Germany

Fax: + 49-621503-4114

Email: MedCLu@t-online.de