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UNUSUAL CASE
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Laparoscopic assisted balloon enteroscopy to detect obscure gastrointestinal bleeding sources missed by capsule endoscopy


1 Department of Oncology and Robotic Surgery, Careggi University Hospital, Florence, Italy
2 Department of Emergency, Careggi University Hospital, Florence, Italy
3 Department of Experimental and Clinical Biomedical Sciences, Gastroenterology Unit, Careggi University Hospital, Florence, Italy
4 Department of Pathology, Pathology Unit, Careggi University Hospital, Florence, Italy

Correspondence Address:
Damiano Bisogni,
Department of Oncology and Robotic Surgery, Careggi University Hospital, Largo Brambilla 3, Florence 50134
Italy
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmas.JMAS_6_20

Jejunoileal neuroendocrine tumours (NETs) are frequently multifocal and represent a consistent source of obscure gastrointestinal bleeding (OGIB). We report the real-life case of a female presenting to our attention for severe episodes of haematochezia caused by multiple localisation of jejunoileal NETs. A discrepancy between pre-operative total body contrast-enhancement computed tomography scan and capsule endoscopy (CE) emerged, in terms of numbers of lesions, so that, as completeness, an intraoperative balloon-assisted enteroscopy (BAE) was carried out, leading to the detection of the multiple lesions missed during CE. In case of obscure gastrointestinal bleeding sources missed by capsule endoscopy, laparoscopic-assisted balloon enteroscopy plays an essential role, allowing both to assess a precise diagnosis and to resect the intestinal bleeding tract.


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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04