Intraoperative gastrointestinal endoscopy in the management of occult gastrointestinal bleeding.

Intraoperative gastrointestinal endoscopy has become an increasingly valuable diagnostic and therapeutic adjunct in the management of a variety of complicated problems in surgical patients. At the Medical College of Georgia, intraoperative gastrointestinal endoscopic technics have been successfully used to locate the site and cause of occult gastrointestinal bleeding; to diagnose, biopsy, and, when appropriate, resect lesions during operations conducted for other pathologic processes; to gain endoscopic access for resection of lesions otherwise inaccessible (endoscopically) by virtue of intestinal distortion caused by adhesions; to guide the operating surgeon to an area of resectable disease through dense adhesions secondary to multiple previous laparotomies; and to enhance diagnosis at laparotomy. The value of intraoperative gastrointestinal endoscopy in lesions resulting in occult gastrointestinal hemorrhage and the value of combined radiographic and intraoperative endoscopic technics in diagnosing and managing occult GI bleeding are discussed.