Intra-operative enteroscopy with a sonde intestinal fiberscope
1994; Elsevier BV; Volume: 40; Issue: 2 Linguagem: Inglês
10.1016/s0016-5107(94)70174-1
ISSN1097-6779
AutoresJames Hoffman, David R. Cave, Desmond H. Birkett,
Tópico(s)Gastrointestinal Tumor Research and Treatment
ResumoIntra-operative enteroscopy plays an important role in identifying sites of bleeding in the small intestine, 1 Ress AM Benacci JC Sarr MG Efficacy of intraoperative enteroscopy in diagnosis and prevention of recurrent, occult gastrointestinal bleeding. Am J Surg. 1992; 163: 94-99 Abstract Full Text PDF PubMed Scopus (123) Google Scholar , 2 Glynn MJ Pendower J Shousha S Parkins RA Recurrent bleeding from idiopathic ulceration of small bowel. BMJ. 1984; 288: 975-976 Crossref PubMed Scopus (12) Google Scholar , 3 Flickinger EG Stanforth AC Sinar DR MacDonald KG Lannin DR Gibson JH Intraoperative video panendoscopy for diagnosing sites of chronic intestinal bleeding. Am J Surg. 1989; 157: 137-144 Abstract Full Text PDF PubMed Scopus (65) Google Scholar , 4 Desa LA Ohri SK Hutton KA Lee H Spencer J Role of intraoperative enteroscopy in obscure gastrointestinal bleeding of small bowel origin. Br J Surg. 1991; 78: 192-195 Crossref PubMed Scopus (94) Google Scholar , 5 Lewis BS Wenger JS Waye JD Small bowel enteroscopy and intraoperative enteroscopy for obscure gastrointestinal bleeding. Am J Gastroenterol. 1991; 86: 171-174 PubMed Google Scholar , 6 Strodel WE Eckhauser FE Knol JA Nostrant TT Dent L Intraoperative fiberoptic endoscopy. Am Surg. 1984; 50: 340-344 PubMed Google Scholar , 7 Lau WY Wong SY Ngan H Fan ST Wong KK Intra-operative localization of bleeding small intestinal lesions. Br J Surg. 1988; 75: 249-251 Crossref PubMed Scopus (25) Google Scholar with success rates for localizing lesions ranging from 58% to 100%. 1 Ress AM Benacci JC Sarr MG Efficacy of intraoperative enteroscopy in diagnosis and prevention of recurrent, occult gastrointestinal bleeding. Am J Surg. 1992; 163: 94-99 Abstract Full Text PDF PubMed Scopus (123) Google Scholar , 3 Flickinger EG Stanforth AC Sinar DR MacDonald KG Lannin DR Gibson JH Intraoperative video panendoscopy for diagnosing sites of chronic intestinal bleeding. Am J Surg. 1989; 157: 137-144 Abstract Full Text PDF PubMed Scopus (65) Google Scholar , 4 Desa LA Ohri SK Hutton KA Lee H Spencer J Role of intraoperative enteroscopy in obscure gastrointestinal bleeding of small bowel origin. Br J Surg. 1991; 78: 192-195 Crossref PubMed Scopus (94) Google Scholar , 5 Lewis BS Wenger JS Waye JD Small bowel enteroscopy and intraoperative enteroscopy for obscure gastrointestinal bleeding. Am J Gastroenterol. 1991; 86: 171-174 PubMed Google Scholar , 8 Bowden TA Hooks UH Teeslink CR Parrish RA Mansberger AR Occult gastrointestinal bleeding: locating the cause. Am Surg. 1980; 40: 80-87 Google Scholar Intra-operative enteroscopy has usually been performed with a video or fiberoptic 164-cm colonoscope or a push-type enteroscope; the instrument is inserted trans-orally or trans-anally, and the surgeon then telescopes the bowel over the enteroscope. 3 Flickinger EG Stanforth AC Sinar DR MacDonald KG Lannin DR Gibson JH Intraoperative video panendoscopy for diagnosing sites of chronic intestinal bleeding. Am J Surg. 1989; 157: 137-144 Abstract Full Text PDF PubMed Scopus (65) Google Scholar , 4 Desa LA Ohri SK Hutton KA Lee H Spencer J Role of intraoperative enteroscopy in obscure gastrointestinal bleeding of small bowel origin. Br J Surg. 1991; 78: 192-195 Crossref PubMed Scopus (94) Google Scholar , 5 Lewis BS Wenger JS Waye JD Small bowel enteroscopy and intraoperative enteroscopy for obscure gastrointestinal bleeding. Am J Gastroenterol. 1991; 86: 171-174 PubMed Google Scholar , 6 Strodel WE Eckhauser FE Knol JA Nostrant TT Dent L Intraoperative fiberoptic endoscopy. Am Surg. 1984; 50: 340-344 PubMed Google Scholar , 7 Lau WY Wong SY Ngan H Fan ST Wong KK Intra-operative localization of bleeding small intestinal lesions. Br J Surg. 1988; 75: 249-251 Crossref PubMed Scopus (25) Google Scholar , 8 Bowden TA Hooks UH Teeslink CR Parrish RA Mansberger AR Occult gastrointestinal bleeding: locating the cause. Am Surg. 1980; 40: 80-87 Google Scholar , 9 Bowden TA Endoscopy of the small intestine. Surg Clin North Am. 1989; 69: 1237-1247 PubMed Google Scholar , 10 Bowden TA Hooks UH Mansberger AR Intraoperative gastrointestinal endoscopy in the management of occult gastrointestinal bleeding. South Med J. 1979; 72: 1532-1534 Crossref PubMed Scopus (22) Google Scholar In some cases an enterotomy is made in the midsection of the small bowel, and the colonoscope is then passed proximally and distally to the incision. 1 Ress AM Benacci JC Sarr MG Efficacy of intraoperative enteroscopy in diagnosis and prevention of recurrent, occult gastrointestinal bleeding. Am J Surg. 1992; 163: 94-99 Abstract Full Text PDF PubMed Scopus (123) Google Scholar , 4 Desa LA Ohri SK Hutton KA Lee H Spencer J Role of intraoperative enteroscopy in obscure gastrointestinal bleeding of small bowel origin. Br J Surg. 1991; 78: 192-195 Crossref PubMed Scopus (94) Google Scholar Although intra-operative enteroscopy with standard instruments has been highly successful in localizing sites of bleeding, the procedure has several disadvantages. It is technically cumbersome, produces mucosal artifacts, and often results in considerable trauma to the small bowel. 3 Flickinger EG Stanforth AC Sinar DR MacDonald KG Lannin DR Gibson JH Intraoperative video panendoscopy for diagnosing sites of chronic intestinal bleeding. Am J Surg. 1989; 157: 137-144 Abstract Full Text PDF PubMed Scopus (65) Google Scholar , 5 Lewis BS Wenger JS Waye JD Small bowel enteroscopy and intraoperative enteroscopy for obscure gastrointestinal bleeding. Am J Gastroenterol. 1991; 86: 171-174 PubMed Google Scholar , 8 Bowden TA Hooks UH Teeslink CR Parrish RA Mansberger AR Occult gastrointestinal bleeding: locating the cause. Am Surg. 1980; 40: 80-87 Google Scholar , 9 Bowden TA Endoscopy of the small intestine. Surg Clin North Am. 1989; 69: 1237-1247 PubMed Google Scholar , 11 Frank MS Brandt LJ Boley SJ Mitsudo SM Iatric submucosal hemorrhage, a pitfall of intraoperative endoscopy. Am J Gastroenterol. 1981; 75: 209-210 PubMed Google Scholar We report the successful intra-operative use of the sonde enteroscope in five consecutive patients.
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