Endoscopic therapies for small-bowel bleeding

Video capsule endoscopy and device-assisted enteroscopy have revolutionized the way bleeding lesions of the small bowel are diagnosed, localized, and treated. Many of the standard techniques for treating upper or lower gastrointestinal tract bleeding, including bipolar electrocoagulation, argon plasma coagulation, injection therapy, and polypectomy, may be applied to bleeding in the small bowel. Rarer conditions, such as small-bowel varices and blue rubber band nevus syndrome, also have the potential to be managed endoscopically. The diagnostic yield of device-assisted enteroscopy for obscure gastrointestinal bleeding ranges from 50% to 90%, and both technical and clinical success in achieving hemostasis have been demonstrated in several large studies.