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MPDr Maneesh PaliwalGastroenterologist & Hepatologist · South Delhi
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GI bleeding

Intestinal bleeding diagnosed in two days after nine days elsewhere

An elderly woman admitted at another hospital for nine days with falling haemoglobin and no diagnosis, transferred to PSRI.

blood-in-stool

Presentation

Recurrent dark stools, transfusion-dependent anaemia, normal upper endoscopy and colonoscopy at the previous centre.

Approach

Repeat careful colonoscopy to the terminal ileum, then capsule endoscopy the next morning, which showed bleeding angiodysplasias in the jejunum. Balloon enteroscopy the same week cauterised the lesions.

Outcome

Haemoglobin stable without further transfusion; discharged on day four; no recurrence at follow-up.

Where it was managed

PSRI Hospital, Sheikh Sarai (procedures, admission) and the Gut Liver Obesity Clinic, Chittaranjan Park (consultations and follow-up).

The lesson

When both scopes are normal, the small bowel is the answer — and capsule plus enteroscopy finds it. 'He is a life saviour to her,' the family wrote.

Representative case based on real outcomes; personal details changed to protect privacy. Individual results vary.

Dr Maneesh Paliwal
Faculty, GI Confluence 2024, New Delhi

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