Occult & Obscure Bleeding
(Gastroenterol 2000;118:197-200 & 201-21)
DEFINITION:
Occult: bleeding that is not visible or hidden and is manifested by positive fecal occult blood testing or iron deficiency anemia
Obscure: clinically observable bleeding with a negative standard evaluation, including: EGD, Colonoscopy, SBS, etc.
ETIOLOGIES:
See Upper and Lower GI bleed etiologies in GI Bleed-UGIB & LGIB (Chapter 6.04), also in the DDX:
Gastrointestinal stromal tumors, leiomyomas, leiomyosarcomas cause >50% of bleeding neoplasms of small intestine
Those under 50 years often have small intestinal tumors as a cause of obscure bleeding
Angiodysplasia (AVMs) or Osler-Weber-Rendu syndrome (OWR)
Dieulafoy’s lesions
Cameron’s erosions (associated with large hiatal hernias)
GAVE (gastric antral vascular ectasia or “watermelon stomach”)
Nonesophageal varices
Portal hypertensive gastropathy
Crohn’s disease
Small bowel erosions, IBD or tumors (i.e. lymphoma, leiomyoma, carcinoid)Stay updated, free articles. Join our Telegram channel
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