Unsuspected ileal stenosis causing obscure GI bleeding in patients with previous abdominal surgery - Diagnosis by capsule endoscopy: A report of two cases

R. de Franchis, E. M. Contessini Avesani, C. Abbiati, E. Rondonotti, S. Zatelli, G. Beccari, M. Primignani, M. Gatti, M. Cappelletti, A. Carnevali, G. Gazzano, M. Vecchi

Research output: Contribution to journalArticle

Abstract

Peri-anastomotic ulcerations may occur in patients with previous abdominal surgery. They may present only with obscure GI bleeding. We report two cases in whom capsule endoscopy identified postsurgical stenoses with ulcers as the cause of obscure GI bleeding. Case 1. A 57-year-old male operated on in 1970 for a post-traumatic diaphragm hernia followed by displacement of the caecum in the upper left abdominal quadrant. Case 2. A 32-year-old female with a salpingectomy for tuberculosis (1978) followed by segmental ileal resection for intestinal obstruction. Both patients had undergone extensive work-up including bidirectional endoscopies and enteroclysis with negative results. Capsule endoscopy with the GIVEN diagnostic system was done. Ileal stenoses with mucosal ulcers in dilated prestenotic loops were observed in both cases. The capsule was retained at the stenosis site, requiring ileal resection and anastomosis. Pathology reports showed mucosal ulcers. In case 2, tuberculosis was ruled out by tissue and faecal polymerase chain reaction and culture. Ileal stenoses with prestenotic ulcerations causing GI bleeding may occur in patients with previous abdominal surgery. Capsule endoscopy may clarify the diagnosis and shorten the diagnostic work-up. However, these patients should be warned that capsule retention requiring surgery might occur.

Original languageEnglish
Pages (from-to)577-584
Number of pages8
JournalDigestive and Liver Disease
Volume35
Issue number8
DOIs
Publication statusPublished - Aug 2003

Fingerprint

Capsule Endoscopy
Pathologic Constriction
Hemorrhage
Ulcer
Capsules
Tuberculosis
Salpingectomy
Intestinal Obstruction
Hernia
Diaphragm
Endoscopy
Pathology
Polymerase Chain Reaction

Keywords

  • Capsule endoscopy
  • Obscure GI bleeding
  • Postsurgical ileal stenosis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Unsuspected ileal stenosis causing obscure GI bleeding in patients with previous abdominal surgery - Diagnosis by capsule endoscopy : A report of two cases. / de Franchis, R.; Contessini Avesani, E. M.; Abbiati, C.; Rondonotti, E.; Zatelli, S.; Beccari, G.; Primignani, M.; Gatti, M.; Cappelletti, M.; Carnevali, A.; Gazzano, G.; Vecchi, M.

In: Digestive and Liver Disease, Vol. 35, No. 8, 08.2003, p. 577-584.

Research output: Contribution to journalArticle

de Franchis, R, Contessini Avesani, EM, Abbiati, C, Rondonotti, E, Zatelli, S, Beccari, G, Primignani, M, Gatti, M, Cappelletti, M, Carnevali, A, Gazzano, G & Vecchi, M 2003, 'Unsuspected ileal stenosis causing obscure GI bleeding in patients with previous abdominal surgery - Diagnosis by capsule endoscopy: A report of two cases', Digestive and Liver Disease, vol. 35, no. 8, pp. 577-584. https://doi.org/10.1016/S1590-8658(03)00279-2
de Franchis, R. ; Contessini Avesani, E. M. ; Abbiati, C. ; Rondonotti, E. ; Zatelli, S. ; Beccari, G. ; Primignani, M. ; Gatti, M. ; Cappelletti, M. ; Carnevali, A. ; Gazzano, G. ; Vecchi, M. / Unsuspected ileal stenosis causing obscure GI bleeding in patients with previous abdominal surgery - Diagnosis by capsule endoscopy : A report of two cases. In: Digestive and Liver Disease. 2003 ; Vol. 35, No. 8. pp. 577-584.
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