Mistakes in small bowel bleeding and how to avoid them

Filters:

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in small bowel bleeding and how to avoid them

Andrea Telese, Alberto Murino, Edward J Despott

Summary

AI Generated

This article addresses frequent mistakes in the investigation and management of small bowel bleeding and proposes strategies to avoid them, despite advances in imaging technologies over the past 17 years.

Small bowel sources account for 5–10% of all gastrointestinal bleeding cases
Technologies including small bowel capsule endoscopy, device-assisted enteroscopy, and dedicated cross-sectional imaging have transformed small bowel investigation over the past 17 years
Definitive management of small bowel bleeding remains challenging even with current advanced imaging
The material is most relevant for clinicians managing gastrointestinal bleeding cases

Download PDF

Was this helpful?

Thanks for your feedback.

This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Lau WY, et al. Preoperative and intraoperative localisation of gastrointestinal bleeding of obscure origin. Gut 1987; 28: 869–877. [Link]

Pennazio M, et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2015; 47: 352–376. [Link]

Gerson LB, et al. ACG Clinical Guideline: Diagnosis and management of small bowel bleeding. Am J Gastroenterol 2015; 110: 1265–1287. [Link]

Raju GS, et al. American Gastroenterological Association (AGA) Institute medical position statement on obscure gastrointestinal bleeding. Gastroenterology 2007; 133: 1694–1696. [Link]

Gunjan D, et al. Small bowel bleeding: a comprehensive review. Gastroenterol Rep (Oxf) 2014; 2: 262–275. [Link]

Zaman A, et al. Push enteroscopy for obscure gastrointestinal bleeding yields a high incidence of proximal lesions within reach of a standard endoscope. Gastrointest Endosc 1998; 47: 372–376. [Link]

Descamps C, et al. 'Missed' upper gastrointestinal tract lesions may explain 'occult' bleeding. Endoscopy 1999; 31: 452–425. [Link]

Lara LF, et al. The rate of lesions found within reach of esophagogastroduodenoscopy during push enteroscopy depends on the type of obscure gastrointestinal bleeding. Endoscopy 2005; 37: 745–750. [Link]

Huprich JE, et al. Prospective blinded comparison of wireless capsule endoscopy and multiphase CT enterography in obscure gastrointestinal bleeding. Radiology 2011; 260: 744–751. [Link]

10.

Shinozaki S, et al. Long-term outcome of patients with obscure gastrointestinal bleeding investigated by double-balloon endoscopy. Clin Gastroenterol Hepatol 2010; 8: 151–158. [Link]

11.

Aniwan S, et al. Urgent double balloon endoscopy provides higher yields than non-urgent double balloon endoscopy in overt obscure gastrointestinal bleeding. Endosc Int Open 2014; 02: E90–E95. [Link]

12.

Singh A, et al. Timing of video capsule endoscopy relative to overt obscure GI bleeding: implications from a retrospective study. Gastrointest Endosc 2013; 77: 761–766. [Link]

13.

Yamada A, et al. Timing of capsule endoscopy influences the diagnosis and outcome in obscure-overt gastrointestinal bleeding. Hepatogastroenterol 2012; 59: 676–679.

14.

Monkemuller K, et al. A retrospective analysis of emergency double-balloon enteroscopy for small-bowel bleeding. Endoscopy 2009; 41: 715–717. [Link]

15.

Rondonotti E, et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review. Endoscopy 2018; 50: 423–446. [Link]

16.

Sanaka MR, et al. Antegrade is more effective than retrograde enteroscopy for evaluation and management of suspected small-bowel disease. Clin Gastroenterol Hepatol 2012; 10: 910–916. [Link]

17.

Sanchez-Yague A, et al. The endoscopic cap that can (with videos). Gastrointest Endosc 2012; 76: 169–178.e2. [Link]

18.

Despott EJ and Murino A. Saline-immersion therapeutic endoscopy (SITE): An evolution of underwater endoscopic lesion resection. Dig Liver Dis 2017; 49: 13. [Link]

19.

Gay G, et al. Outcome of capsule endoscopy in determining indication and route for push-and-pull enteroscopy. Endoscopy 2006; 38: 49–58. [Link]

20.

Fry LC, et al. Capsule endoscopy increases the diagnostic yield of double balloon enteroscopy in patients being investigated for obscure gastrointestinal bleeding. Arch Gastroenterohepatol 2012; 29: 9–14.

21.

Yano T, et al. Endoscopic classification of vascular lesions of the small intestine (with videos). Gastrointest Endosc 2008; 67: 169–172. [Link]

22.

Svarta S, et al. Diagnostic yield of repeat capsule endoscopy and the effect on subsequent patient management . Canad J Gastroenterol 2010; 24: 441–444. [Link]

23.

Jones BH, et al. Yield of repeat wireless video capsule endoscopy in patients with obscure gastrointestinal bleeding. Am J Gastroenterol 2005; 100: 1058–1064. [Link]

24.

Byeon JS, et al. Is a repeat double balloon endoscopy in the same direction useful in patients with recurrent obscure gastrointestinal bleeding? J Clin Gastroenterol 2013; 47: 496–500. [Link]

25.

Badr Al-Bawardy, et al. Outcomes of repeat balloon assisted enteroscopy in small-bowel bleeding. Endosc Int Open 2018; 6: E694–E699. [Link]

26.

Shinozaki S, et al. Long-term outcome of patients with obscure gastrointestinal bleeding investigated by double-balloon endoscopy. Clin Gastroenterol Hepatol 2010; 8: 151–158. [Link]

Abstract

Over the past 17 years, the disruptive impact of technologies including small bowel capsule endoscopy (SBCE), device-assisted enteroscopy (DAE) and dedicated cross-sectional imaging has transformed the investigation and management of small bowel pathology. Although a small bowel source only accounts for 5–10% of all cases of gastrointestinal bleeding,definitive management of small bowel bleeding even in the current era of advanced imaging, can still pose formidable challenges. In this brief article, we highlight frequent mistakes made in the investigation and management of small bowel bleeding and discuss strategies for their avoidance.

Topics

Small Intestine & Nutrition

Citation

Despott EJ, Telese A and Murino A. Mistakes in small bowel bleeding and how to avoid them. UEG Education 2018; 18: 27–29.

Published

2024

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update

Dror Shouval

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Nutrition in coeliac disease for a clinician with Cristian Costas

Pradeep Mundre

Revised Guidelines for the Treatment and Follow-Up of Gallbladder Polyps Do Not Reduce Unwarranted Cholecystectomies: Results of the POLYP Study

Elise A.J. de Savornin Lohman

Mistakes in Familial Mediterranean Fever and how to avoid them

Gagik Hakobyan

UEG Mistakes In Articles

New

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Spyridon Pantzios, Ioannis Elefsiniotis, Christos Triantos

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Lau WY, et al. Preoperative and intraoperative localisation of gastrointestinal bleeding of obscure origin. Gut 1987; 28: 869–877. [Link]

Gerson LB, et al. ACG Clinical Guideline: Diagnosis and management of small bowel bleeding. Am J Gastroenterol 2015; 110: 1265–1287. [Link]

Raju GS, et al. American Gastroenterological Association (AGA) Institute medical position statement on obscure gastrointestinal bleeding. Gastroenterology 2007; 133: 1694–1696. [Link]

Gunjan D, et al. Small bowel bleeding: a comprehensive review. Gastroenterol Rep (Oxf) 2014; 2: 262–275. [Link]

Descamps C, et al. 'Missed' upper gastrointestinal tract lesions may explain 'occult' bleeding. Endoscopy 1999; 31: 452–425. [Link]

Huprich JE, et al. Prospective blinded comparison of wireless capsule endoscopy and multiphase CT enterography in obscure gastrointestinal bleeding. Radiology 2011; 260: 744–751. [Link]

10.

Shinozaki S, et al. Long-term outcome of patients with obscure gastrointestinal bleeding investigated by double-balloon endoscopy. Clin Gastroenterol Hepatol 2010; 8: 151–158. [Link]

11.

12.

Singh A, et al. Timing of video capsule endoscopy relative to overt obscure GI bleeding: implications from a retrospective study. Gastrointest Endosc 2013; 77: 761–766. [Link]

13.

Yamada A, et al. Timing of capsule endoscopy influences the diagnosis and outcome in obscure-overt gastrointestinal bleeding. Hepatogastroenterol 2012; 59: 676–679.

14.

Monkemuller K, et al. A retrospective analysis of emergency double-balloon enteroscopy for small-bowel bleeding. Endoscopy 2009; 41: 715–717. [Link]

15.

16.

Sanaka MR, et al. Antegrade is more effective than retrograde enteroscopy for evaluation and management of suspected small-bowel disease. Clin Gastroenterol Hepatol 2012; 10: 910–916. [Link]

17.

Sanchez-Yague A, et al. The endoscopic cap that can (with videos). Gastrointest Endosc 2012; 76: 169–178.e2. [Link]

18.

Despott EJ and Murino A. Saline-immersion therapeutic endoscopy (SITE): An evolution of underwater endoscopic lesion resection. Dig Liver Dis 2017; 49: 13. [Link]

19.

Gay G, et al. Outcome of capsule endoscopy in determining indication and route for push-and-pull enteroscopy. Endoscopy 2006; 38: 49–58. [Link]

20.

21.

Yano T, et al. Endoscopic classification of vascular lesions of the small intestine (with videos). Gastrointest Endosc 2008; 67: 169–172. [Link]

22.

Svarta S, et al. Diagnostic yield of repeat capsule endoscopy and the effect on subsequent patient management . Canad J Gastroenterol 2010; 24: 441–444. [Link]

23.

Jones BH, et al. Yield of repeat wireless video capsule endoscopy in patients with obscure gastrointestinal bleeding. Am J Gastroenterol 2005; 100: 1058–1064. [Link]

24.

Byeon JS, et al. Is a repeat double balloon endoscopy in the same direction useful in patients with recurrent obscure gastrointestinal bleeding? J Clin Gastroenterol 2013; 47: 496–500. [Link]

25.

Badr Al-Bawardy, et al. Outcomes of repeat balloon assisted enteroscopy in small-bowel bleeding. Endosc Int Open 2018; 6: E694–E699. [Link]

26.

Shinozaki S, et al. Long-term outcome of patients with obscure gastrointestinal bleeding investigated by double-balloon endoscopy. Clin Gastroenterol Hepatol 2010; 8: 151–158. [Link]

Abstract

Liver cancer is the sixth most common cancer and the third leading cause of cancer-related death. Hepatocellular carcinoma (HCC) accounts for about 90% of cases and mostly arises in chronic liver disease, especially cirrhosis. Viral hepatitis remains a leading cause, but alcohol-related disease and MASLD are rising. With immune checkpoint inhibitors transforming HCC management, it is timely to highlight common mistakes across screening, staging, diagnosis and treatment.

Topics

Digestive Oncology Hepatobiliary

Published

2026

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update

Dror Shouval

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Nutrition in coeliac disease for a clinician with Cristian Costas

Pradeep Mundre

Revised Guidelines for the Treatment and Follow-Up of Gallbladder Polyps Do Not Reduce Unwarranted Cholecystectomies: Results of the POLYP Study

Elise A.J. de Savornin Lohman

Mistakes in Familial Mediterranean Fever and how to avoid them

Gagik Hakobyan

UEG Standards and Guidelines

New

Clinical Practice Guideline

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update

Dror Shouval

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Guideline

Abstract

Objective

To provide an updated, evidence-based European Crohn’s and Colitis Organisation [ECCO]–European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN] guideline for the management, monitoring, and long-term care of pediatric Crohn’s disease [CD].

Methods

A multidisciplinary panel of 27 experts followed ECCO Standard Operating Procedures for guideline development. A systematic review of studies published between January 2018 and October 2024, with targeted updates through June 2025, was conducted across MEDLINE, EMBASE, and Cochrane Central. Evidence was graded using the Oxford Centre for Evidence-Based Medicine levels. Draft statements underwent two Delphi voting rounds involving the guideline panel, ECCO National Representatives, and an international sounding board; statements achieving ≥80% agreement were accepted.

Results

This guideline provides updated recommendations across major domains of pediatric CD care, including risk stratification, treatment targets, induction and maintenance strategies, nutritional therapies, therapeutic drug monitoring, and the roles of imaging and endoscopy. High-risk patients should start anti-TNF therapy as first-line treatment, with proactive and reactive therapeutic drug monitoring to enhance efficacy. For low-risk luminal disease, exclusive enteral nutrition or the Crohn’s Disease Exclusion Diet with partial enteral nutrition are preferred induction options. Long-term management emphasizes achieving endoscopic remission, normal growth, improved quality of life, and reduction of bowel damage. This guideline also reviews emerging advanced therapies, including biologics and small molecules, which are increasingly used in practice but generally not yet approved for pediatric CD, to inform clinicians about their potential role.

Conclusions

This updated ECCO–ESPGHAN guideline integrates new pediatric evidence with contemporary adult data and treat-to-target principles, providing practical recommendations to support personalized, multidisciplinary, and proactive management aimed at improving long-term outcomes in pediatric CD.

Publisher

European Crohn’s and Colitis Organisation

Guideline

Clinical Practice Guideline

Topics

IBD Paediatrics

Citation

Journal of Crohn's and Colitis, Volume 20, Issue 8, August 2026

Published

2026

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update

Dror Shouval

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Nutrition in coeliac disease for a clinician with Cristian Costas

Pradeep Mundre

Revised Guidelines for the Treatment and Follow-Up of Gallbladder Polyps Do Not Reduce Unwarranted Cholecystectomies: Results of the POLYP Study

Elise A.J. de Savornin Lohman

Mistakes in Familial Mediterranean Fever and how to avoid them

Gagik Hakobyan

UEG Standards and Guidelines

Clinical Practice Guideline

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Guideline

ABSTRACT

Pain is often the presenting symptom of acute pancreatitis (AP) and has a prognostic significance, with poorly treated pain affecting patient outcomes. Despite this, there are currently no international recommendations for pain management in patients admitted with AP. This current guideline was developed following the United European Gastroenterology framework for the development of high-quality clinical guidelines. Nine working groups were formed to develop statements on pain management in AP from admission to discharge. After systematic literature reviews, the evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation methodology, as appropriate. Statements and comments were developed by the working groups and voted using three rounds of Delphi method. The guidelines concluded that acute postoperative pain management guidelines are applicable for treating acute pain due to AP. The numerical rating scale is preferred for pain assessment because of better compliance. Opioids currently form the cornerstone of severe pain management. Potent opioids such as buprenorphine and pentazocine provide superior pain relief over non-opioid medications and decrease the need for rescue analgesia. Current evidence does not consistently demonstrate harm from opioids in AP. In patients with severe pain, safety concerns should not delay the timely use of opioids to ensure adequate pain management. Specific recommendations concerning the use of epidural analgesia, acupuncture and management of pain in the paediatric population and during pregnancy are provided based on evidence and expert opinions. Finally, the unmet needs for future research were discussed and proposed.

Guideline

Clinical Practice Guideline

Topics

Pancreas

Citation

United European Gastroenterology Journal, 2026

Published

2026

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update

Dror Shouval

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Nutrition in coeliac disease for a clinician with Cristian Costas

Pradeep Mundre

Revised Guidelines for the Treatment and Follow-Up of Gallbladder Polyps Do Not Reduce Unwarranted Cholecystectomies: Results of the POLYP Study

Elise A.J. de Savornin Lohman

Mistakes in Familial Mediterranean Fever and how to avoid them

Gagik Hakobyan

UEG Podcast Episode

UEG Podcast

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Nutrition in coeliac disease for a clinician with Cristian Costas

Pradeep Mundre

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Abstract

Topics

Small Intestine & Nutrition

Published

2026

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update

Dror Shouval

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Nutrition in coeliac disease for a clinician with Cristian Costas

Pradeep Mundre

Revised Guidelines for the Treatment and Follow-Up of Gallbladder Polyps Do Not Reduce Unwarranted Cholecystectomies: Results of the POLYP Study

Elise A.J. de Savornin Lohman

Mistakes in Familial Mediterranean Fever and how to avoid them

Gagik Hakobyan

UEG Standards and Guidelines

Clinical Practice Guideline

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Revised Guidelines for the Treatment and Follow-Up of Gallbladder Polyps Do Not Reduce Unwarranted Cholecystectomies: Results of the POLYP Study

Mike van Dooren, Elise A.J. de Savornin Lohman

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

Guideline

ABSTRACT

Background

Gallbladder polyps are seen in up to 7% of adults and carry a low malignancy risk. Guidelines on indication for surgery and follow-up remain controversial because of regional differences in the development of malignancy. This study compares European practice guidelines for gallbladder polyps and assesses the percentage of patients in whom cholecystectomy was indicated according to the guidelines with a true adenoma postoperatively.

Methods

Dutch patients with active follow-up or surgery for gallbladder polyps between 2018 and 2020 in 26 participating centres were included. Data on demographics, imaging characteristics, surgery and histopathology were assessed. Indications for cholecystectomy were examined for all patients comparing 2017 and 2022 European guidelines.

Results

A cohort of 302 patients was included. Patients in follow-up underwent imaging three times (median) and were followed up during a median of 23.2 months (IQR 10.9–47.4). In total, 88 patients (29%) underwent cholecystectomy after a median period of 23 months and a median of two instances of imaging. In 71 of 88 patients (81%) who underwent cholecystectomy, the gallbladder polyps was a valid indication for cholecystectomy according to 2017 guidelines, compared to 68 of 88 (77%) according to 2022 guidelines. The difference only occurred due to age as a risk factor which changed from 50 to 60 years of age. Of 71 operated patients, non-neoplastic polyps were found in 49 (69%), no gallbladder wall abnormality was found in 23 (32%). An adenoma was found in six patients (9%), of which three had low grade dysplasia and one had high grade dysplasia.

Discussion

Despite revision of guidelines in 2022, a significant number of patients still undergo follow-up and cholecystectomy for non-neoplastic gallbladder polyps, indicating the need for a more comprehensive risk assessment algorithm in the management of gallbladder polyps.

Guideline

Clinical Practice Guideline

Topics

Hepatobiliary Surgery

Citation

United European Gastroenterology Journal, 2025; 13:1133–1140

Published

2025

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update

Dror Shouval

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Nutrition in coeliac disease for a clinician with Cristian Costas

Pradeep Mundre

Revised Guidelines for the Treatment and Follow-Up of Gallbladder Polyps Do Not Reduce Unwarranted Cholecystectomies: Results of the POLYP Study

Elise A.J. de Savornin Lohman

Mistakes in Familial Mediterranean Fever and how to avoid them

Gagik Hakobyan

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in Familial Mediterranean Fever and how to avoid them

Manik Gemilyan, Gagik Hakobyan

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10

Lau WY, et al. Preoperative and intraoperative localisation of gastrointestinal bleeding of obscure origin. Gut 1987; 28: 869–877. [Link]

Gerson LB, et al. ACG Clinical Guideline: Diagnosis and management of small bowel bleeding. Am J Gastroenterol 2015; 110: 1265–1287. [Link]

Raju GS, et al. American Gastroenterological Association (AGA) Institute medical position statement on obscure gastrointestinal bleeding. Gastroenterology 2007; 133: 1694–1696. [Link]

Gunjan D, et al. Small bowel bleeding: a comprehensive review. Gastroenterol Rep (Oxf) 2014; 2: 262–275. [Link]

Descamps C, et al. 'Missed' upper gastrointestinal tract lesions may explain 'occult' bleeding. Endoscopy 1999; 31: 452–425. [Link]

Huprich JE, et al. Prospective blinded comparison of wireless capsule endoscopy and multiphase CT enterography in obscure gastrointestinal bleeding. Radiology 2011; 260: 744–751. [Link]

10.

Shinozaki S, et al. Long-term outcome of patients with obscure gastrointestinal bleeding investigated by double-balloon endoscopy. Clin Gastroenterol Hepatol 2010; 8: 151–158. [Link]

11.

12.

Singh A, et al. Timing of video capsule endoscopy relative to overt obscure GI bleeding: implications from a retrospective study. Gastrointest Endosc 2013; 77: 761–766. [Link]

13.

Yamada A, et al. Timing of capsule endoscopy influences the diagnosis and outcome in obscure-overt gastrointestinal bleeding. Hepatogastroenterol 2012; 59: 676–679.

14.

Monkemuller K, et al. A retrospective analysis of emergency double-balloon enteroscopy for small-bowel bleeding. Endoscopy 2009; 41: 715–717. [Link]

15.

16.

Sanaka MR, et al. Antegrade is more effective than retrograde enteroscopy for evaluation and management of suspected small-bowel disease. Clin Gastroenterol Hepatol 2012; 10: 910–916. [Link]

17.

Sanchez-Yague A, et al. The endoscopic cap that can (with videos). Gastrointest Endosc 2012; 76: 169–178.e2. [Link]

18.

Despott EJ and Murino A. Saline-immersion therapeutic endoscopy (SITE): An evolution of underwater endoscopic lesion resection. Dig Liver Dis 2017; 49: 13. [Link]

19.

Gay G, et al. Outcome of capsule endoscopy in determining indication and route for push-and-pull enteroscopy. Endoscopy 2006; 38: 49–58. [Link]

20.

21.

Yano T, et al. Endoscopic classification of vascular lesions of the small intestine (with videos). Gastrointest Endosc 2008; 67: 169–172. [Link]

22.

Svarta S, et al. Diagnostic yield of repeat capsule endoscopy and the effect on subsequent patient management . Canad J Gastroenterol 2010; 24: 441–444. [Link]

23.

Jones BH, et al. Yield of repeat wireless video capsule endoscopy in patients with obscure gastrointestinal bleeding. Am J Gastroenterol 2005; 100: 1058–1064. [Link]

24.

Byeon JS, et al. Is a repeat double balloon endoscopy in the same direction useful in patients with recurrent obscure gastrointestinal bleeding? J Clin Gastroenterol 2013; 47: 496–500. [Link]

25.

Badr Al-Bawardy, et al. Outcomes of repeat balloon assisted enteroscopy in small-bowel bleeding. Endosc Int Open 2018; 6: E694–E699. [Link]

26.

Shinozaki S, et al. Long-term outcome of patients with obscure gastrointestinal bleeding investigated by double-balloon endoscopy. Clin Gastroenterol Hepatol 2010; 8: 151–158. [Link]

Abstract

Familial Mediterranean fever (FMF), also called periodic disease, Armenian disease, etc., is a prototypical autoinflammatory disorder where the underlying mechanism is the dysfunction of innate immunity, resulting in unprovoked episodes of inflammation.¹ Although considered rare worldwide, it is prevalent in people of Mediterranean origin; however, one can expect to encounter patients in all parts of the modern world. FMF is a monogenic disease with autosomal recessive inheritance.² Unlike other monogenic disorders, the diagnosis remains largely clinical, and it is important to understand the limitations of genetic testing. Another distinguishing feature is the well-established effectiveness of lifelong monotherapy with colchicine in preventing attacks and complications.³

Topics

Primary Care

Published

2025

More Like This:

Mistakes in the management of hepatocellular carcinoma and how to avoid them

Christos Triantos

Management of paediatric Crohn’s disease: an ECCO-ESPGHAN guideline update

Dror Shouval

European Interdisciplinary Guidelines on Pain Management in Acute Pancreatitis: UEG, EPC, EDS, ESDO, EAGEN, ESPGHAN, ESGAR, and ESPCG Evidence-Based Recommendations

Sanjay Pandanaboyana

Nutrition in coeliac disease for a clinician with Cristian Costas

Pradeep Mundre

Revised Guidelines for the Treatment and Follow-Up of Gallbladder Polyps Do Not Reduce Unwarranted Cholecystectomies: Results of the POLYP Study

Elise A.J. de Savornin Lohman

Mistakes in Familial Mediterranean Fever and how to avoid them

Gagik Hakobyan