Aims To evaluate sources of intestinal bleeding and compare their clinical features.
Methods From 14.02.2007 to 10.03.2019 229 patients (m-117, f-112, mean age 52,3±18,3 years,
range 17-89) were admitted to our clinics with GIB of unknown source. Obscure overt
bleeding had 142 (62,0%) pts, obscure occult bleeding - 87 (38,0%) pts, associated
with severe anemia in 86 (37,5%) pts, moderate anemia - in 87 (37,9%) pts and mild
anemia - in 56 (24,4%) pts. Other complaints were: abdominal pain in 50 (51,0%) pts,
diarrhea in 26 (26,5%) pts, nausea/vomiting in 22 (22,4%) pts. Videocapsule enteroscopy
was performed in 179 (78,2%) pts, balloon-assisted enteroscopy - in 146 (63,7%) pts.
Results The source of GIB was found in 191 (83,4%) pts: small bowel (SB) - in 170 (89,0%)
pts; upper/lower GI tract - in 21 (11,0%) pts, no pathology - in 38 (16,6%) pts. The
sources of SB bleeding included vessel malformations (VM) in 65 (35,7%) pts, tumors
- in 54 (29,7%) pts, erosive/ulcerative enteropathy - in 42 (23,1%) pts, diverticula
- in 9 (5,3%) pts (incl. Meckel’s diverticulum (6)). VM were more common in patients
older than 55 years, tumors and enteritis - up to 55 (p=0.03700). Pts with VM and
tumors predominantly had obscure overt bleeding, pts with enteritis - obscure occult
bleeding (p=0.03795). The period of tumors detection was longer year, than the diagnosis
of enteritis (p=0.00648). Having tumors and enteritis patients more often experienced
abdominal pain, that those with VM (p=0.00049); pts with enteritis more often complained
of diarrhea than pts with VM and tumors (p=0.00001). All pts with SB diverticula had
overt GIB, apparent with severe anemia, without any other complaints.
Conclusions The knowledge about different clinical manifestation of certain sources of intestinal
bleeding may be useful in complex diagnostics.
