The Unstable Patient with Obscure Gastrointestinal Bleeding: Surgical and Non-surgical Management

Obscure gastrointestinal bleeding (OGIB) is defined as intermittent or persistent loss of blood that occurs or reoccurs after evaluation by upper gastrointestinal and lower gastrointestinal endoscopy [Zuckerman et al. Gastroenterology 118:201–221, 2000]. The clinical presentation can vary dramatically, from occult blood loss that is only detectible by hemoccult testing, manifesting as iron deficiency to overt clinical manifestations of hematemesis, melena, or hematochezia requiring transfusion and hospitalization.