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GASTROINTESTINAL BLEEDING Part 2 Stephanie Faith C. Bautista COMMON CAUSES Gastrointestinal Bleeding Anal fissure Aorto-enteric fistula Cancer of the small intestine Angiodysplasias ď‚·Celiac sprue Colon cancer Dieulafoy's lesion Crohn's disease Esophageal varices Shigella stool - Dysentery Esophagitis Entamoeba histolytica Gastric (stomach) ulcer Hemorrhoids Intestinal polyps Duodenal ulcer Ischemic bowel Radiation injury to the bowel Nosebleed Intestinal vasculitis Meckel's diverticulum Portal hypertensive gastropathy intussusception Stomach cancer Ulcerative colitis Endoscopy Endoscopic images of a duodenal ulcer A physician using an endoscope An example of a flexible endoscope. Gastrointestinal Tract Endoscopy Gastrointestinal Videoscope Gastrointestinal Tract Endoscopy System for Observation Using Specific Light Spectra. World's First Gastrointestinal Videoscopes with Auto Fluorescence Imaging. The AFI produces enhanced images showing differences in the coloration of tumorous and normal mucosa by irradiating blue light on mucosa. Colonovideoscope AFI offers an easy way to distinguish between normal and tumorous tissue by combining an auto fluorescence image with the image of green reflected light which depicts the absorbed light of hemoglobin, so that normal tissue appears pale green, tumorous tissue magenta, and deep blood vessels dark green. Early stomach cancer imaging under normal light Early stomach cancer imaging of chromoendoscopy under normal light Early stomach cancer imaging by AFI Angiogram Arteriogram of patient with acute massive gastrointestinal bleeding, localizing the source of the bleeding to the ascending colon (arrow). Enteroscopy The double-balloon enteroscope can also be passed in retrograde fashion, through the colon and into the ileum to visualize the end of the small bowel. Double-balloon enteroscopy, also known as push-and-pull enteroscopy is an endoscopic technique for visualization of the small bowel Enteroscopy The technique involves the use of a balloon at the end of a special enteroscope camera and an overtube, which is a tube that fits over the endoscope, and which is also fitted with a balloon. The procedure is usually done under general anesthesia, but may be done with the use of conscious sedation. The enteroscope and overtube are inserted through the mouth and passed in conventional fashion (that is, as with gastroscopy) into the small bowel. Following this, the endoscope is advanced a small distance in front of the overtube and the balloon at the end is inflated. Using the assistance of friction at the interface of the enteroscope and intestinal wall, the small bowel is accordioned back to the overtube. The overtube balloon is then deployed, and the enteroscope balloon is deflated. The process is then continued until the entire small bowel is visualized. Capsule Endoscopy Sigmoidoscopy