Emergency Total Intraoperative Enteroscopy Using a Colonoscope

Hemodynamically unstable lower gastrointestinal bleeding is a challenge for on-call teams, especially when symptom severity leaves no time to apply diagnostic techniques. While colonoscopy and gastroduodenoscopy performed before arteriography or scintigraphy are considered the usual diagnostic tools, capsule endoscopy provides new options in patients with stable digestive bleeding that is difficult to locate. Computed tomography (CT) angiography is beginning to replace arteriography and labeled red cell scintigraphy. Nonetheless, the primary objective is to locate the bleeding source, and, in cases where this must be located by surgery, intraoperative enteroscopy using a colonoscopy can be applied. In fact, intraoperative enteroscopy is considered effective from a diagnostic and therapeutic perspective in selected patients, for example, those with severe gastrointestinal bleeding of no apparent etiology and for whom other diagnostic techniques are ineffective or unavailable. This technique ensures that surgical resection is minimally invasive.