Successful treatment of obscure gastrointestinal bleeding with intraoperative enteroscopy

A 51-year-old man was referred to our institution with persistent iron deficiency anemia. Initial gastroduodenoscopy and colonoscopy at his local hospital were unremarkable. A subsequent small bowel capsule endoscopy revealed a distal small bowel polyp with evidence of fresh bleeding ([Fig. 1]). A triple-phase abdominal computed tomography scan confirmed a 13-mm vascular polypoid lesion within the distal small bowel, with hyperenhancement on the arterial phase ([Fig. 2]). After a discussion in a multidisciplinary team meeting, it was decided that surgical resection guided by intraoperative enteroscopy to localize the lesion would be the most appropriate course of action.