A case of small intestinal bleeding during anti-coagulant therapy diagnosed by capsule endoscopy

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  • 抗凝固治療中に発症し，カプセル内視鏡で診断された小腸出血の一症例

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Abstract

Obscure gastrointestinal bleeding (OGIB) is defined as bleeding from the gastrointestinal tract, wherein the focus of bleeding cannot be clearly identified after upper and lower endoscopic examination. We report a case of OGIB for which the focus of bleeding was detected by capsule and double-balloon endoscopic examination. A 72-year-old man, who had regularly taken aspirin, was admitted to our hospital with severe melena. A routine upper and lower endoscopic examination could not detect the focus of bleeding. We discontinued aspirin treatment after admission because of the continuous melena. Further examination using capsule endoscopy (CE) on the 18th hospital day showed multiple ulcerations in the small intestine. The small bowel was emergently resected because progression of the ulcerations was observed by double-balloon endoscopy (DBE). The specimen showed multiple mesenteric arteriole infarctions. Because the discontinuation of anticoagulant agents increases the thrombotic risk, early examination using CE and/or DBE should be performed for OGIB.

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