Copyright ©2009 Baishideng. All rights reserved.
World J Gastrointest Endosc. Oct 15, 2009; 1(1): 3-6
Published online Oct 15, 2009. doi: 10.4253/wjge.v1.i1.3
Occult and obscure gastrointestinal bleeding: Causes and diagnostic approach in 2009
Giampaolo Bresci
Giampaolo Bresci, UO Gastroenterrologia, AOUPisana, Pisa 56125, Italy
Author contributions: Bresci G solely contributed to this paper.
Correspondence to: Giampaolo Bresci, MD, UO Gastroenterrologia, AOUPisana, Via a della spina 11, 56125 Pisa, Italy. gbresci@libero.it
Telephone: +39-50-45227  Fax: +39-50-45227
Received: December 8, 2008
Revised: February 10, 2009
Accepted: February 17, 2009
Published online: October 15, 2009

Gastrointestinal bleeding can be obscure or occult (OGIB), the causes and diagnostic approach will be discussed in this editorial. The evaluation of OGIB consists on a judicious search of the cause of bleeding, which should be guided by the clinical history and physical findings. The standard approach to patients with OGIB is to directly evaluate the gastrointestinal tract by endoscopy, abdominal computed tomography, angiography, radionuclide scanning, capsule endoscopy. The source of OGIB can be identified in 85%-90%, no bleeding sites will be found in about 5%-10% of cases. Even if the bleedings originating from the small bowel are not frequent in clinical practice (7.6% of all digestive haemorrhages, in our casuistry), they are notoriously difficult to diagnose. In spite of progress, however, a number of OGIB still remain problematic to deal with at present in the clinical context due to both the difficulty in exactly identifying the site and nature of the underlying source and the difficulty in applying affective and durable diagnostic approaches so no single technique has emerged as the most efficient way to evaluate OGIB.

Keywords: Occult gastrointestinal bleeding, Obscure gastrointestinal bleeding, Bleeding, Gastrointestinal endoscopy