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Obscure gastrointestinal bleeding — ABIM Board MCQ

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ModerateGastroenterology/HepatologyObscure gastrointestinal bleedingABIM Board

A 71-year-old man has recurrent melena and iron-deficiency anemia. EGD and colonoscopy have each been repeated twice and show no bleeding source. CT angiography is negative because he is not actively bleeding. He is hemodynamically stable. Which of the following is the most appropriate diagnostic study?

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Correct answer: C — Video capsule endoscopy

Stable suspected small-bowel bleeding after negative EGD and colonoscopy is usually evaluated with capsule endoscopy. Deep enteroscopy can follow for therapy or tissue diagnosis depending on capsule findings.

Reference: ACG Small Bowel Bleeding Guideline