Intra-operative enteroscopy for obscure gastrointestinal bleeding

Small bowel enteroscopy has been reported useful in the non-surgical evalua tion of the small intestine in patients with obscure gastrointestinal bleed ing but findings may be limited due to incomplete small bowel intubation an d a lack of tip deflection. Intra-operative enteroscopy (IOE) is accepted a s the ultimate diagnostic procedure for complete evaluation of the small bo wel in these patients. Two patients with obscure gastrointestinal bleeding and deep anemia underwe nt IOE during surgical exploration. Angiodysplastic lesion with a diameter of 3cm was found at jejunum in the first patient and segmental jejunal rese ction was performed. Enteroscopy showed red punctate lesions with a diamete r of 1-3mm located at proximal jejunum and extending to the ileum in the se cond patient. Total jejunal resection was performed. There was no recurrenc e of gastrointestinal bleeding during 36 months follow-up.