{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T18:07:22Z","timestamp":1777918042616,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2007,9,1]],"date-time":"2007-09-01T00:00:00Z","timestamp":1188604800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tumori"],"published-print":{"date-parts":[[2007,9]]},"abstract":"\n Aims and Background<\/jats:title>\n Occult\/obscure gastrointestinal bleeding is often problematic to diagnose. It often leads to delayed treatment, a particularly dangerous circumstance when tumor origins are involved. This study reports the six-year experience of an Italian Surgery Center in the identification of the nature (tumor versus non tumor) and site of origin (upper, middle, lower gastrointestinal tract) of occult\/obscure bleeding requiring hospitalization, as well as in its treatment.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Diagnostic instrumental examinations employed were: esophagogastroduodenoscopy, rectocolonoscopy, computerized tomography small bowel follow-through examination, capsule endoscopy, biopsy, angiography, abdominal computerized tomography scans and ultrasound. Therapies included: interventional radiology and surgery.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Thirty-five cases of obscure and 27 cases of occult bleeding were examined; all received a definite diagnosis during hospitalization. In the cases with obscure bleeding the diagnosis was inflammatory bowel disease (n = 7), angiodysplasia (5 gastric, 2 duodenal, 2 jejunal, 3 ileal, 4 right colon), small bowel tumors (4 non-Hodgkin lymphomas, 1 leiomyoma, 6 adenocarcinomas), and gastric metaplasia of Meckel's diverticulum (n = 1). There were significantly more nontumor lesions than tumors (P <0.005), and a middle tract source was significantly more frequent than upper\/lower tract sources (P <0.0001). Intestinal resections were performed for all small bowel tumors (8 laparotomic, 3 laparoscopic), 5 angiodysplasias, all cases of inflammatory bowel disease and gastric metaplasia of Meckel's diverticulum; arterial embolization was performed for 11 angiodysplasias. In the cases with occult bleeding the diagnosis was sigmoid colon polyps in 6 (treatment, endoscopic polypectomy) and right colon cancer in 21 (treatment, right hemicolectomy). There were significantly more tumors than nontumor lesions (P <0.0001); all derived from the lower gastrointestinal tract. In all cases, the interventions resolved the bleeding completely.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The results show that more than 50% of cases with obscure\/occult bleeding requiring hospitalization are motivated by malignant gastrointestinal tumors, 34% of which are located in the small bowel, usually a difficult tract to explore. Thanks to modern technology, however, their diagnosis and treatment can nowadays be promptly and successfully achieved.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/030089160709300509","type":"journal-article","created":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T03:50:47Z","timestamp":1519703447000},"page":"461-466","source":"Crossref","is-referenced-by-count":7,"title":["Tumor vs Non-Tumor Origin of Occult and Obscure Gastrointestinal Bleeding Requiring Hospitalization"],"prefix":"10.1177","volume":"93","author":[{"given":"Raffaele","family":"Costantini","sequence":"first","affiliation":[{"name":"Department of General and Laparoscopic Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierpaolo","family":"De Nicola","sequence":"additional","affiliation":[{"name":"Department of General and Laparoscopic Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Bianco","sequence":"additional","affiliation":[{"name":"Department of General and Laparoscopic Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio Raffaele","family":"Cotroneo","sequence":"additional","affiliation":[{"name":"Institute of Radiology, \u201cG. D'Annunzio\u201d University of Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Iezzi","sequence":"additional","affiliation":[{"name":"Institute of Radiology, \u201cG. D'Annunzio\u201d University of Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Di Bartolomeo","sequence":"additional","affiliation":[{"name":"Department of General and Laparoscopic Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Innocenti","sequence":"additional","affiliation":[{"name":"Department of General and Laparoscopic Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2007,9,1]]},"reference":[{"key":"bibr1-030089160709300509","first-page":"875","volume":"69","author":"Mitchell S.H.","year":"2004","journal-title":"Am Fam Physician"},{"key":"bibr2-030089160709300509","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-861419"},{"key":"bibr3-030089160709300509","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(00)70430-6"},{"key":"bibr4-030089160709300509","doi-asserted-by":"publisher","DOI":"10.1053\/bega.2000.0161"},{"key":"bibr5-030089160709300509","first-page":"2143","volume":"89","author":"Chong J.","year":"1994","journal-title":"Am J Gastroenterol"},{"key":"bibr6-030089160709300509","doi-asserted-by":"publisher","DOI":"10.1136\/gut.37.3.346"},{"key":"bibr7-030089160709300509","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(00)00447-5"},{"key":"bibr8-030089160709300509","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1005656"},{"key":"bibr9-030089160709300509","first-page":"659","volume":"104","author":"Chao C.C.","year":"2005","journal-title":"J Formos Med Assoc"},{"key":"bibr10-030089160709300509","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.08.029"},{"key":"bibr11-030089160709300509","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-005-0049-1"},{"key":"bibr12-030089160709300509","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199907013410107"},{"key":"bibr13-030089160709300509","first-page":"745","volume":"36","author":"Lara L.F.","year":"2004","journal-title":"Endoscopoy"},{"key":"bibr14-030089160709300509","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-000-0039-3"},{"key":"bibr15-030089160709300509","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(04)00168-3"},{"key":"bibr16-030089160709300509","doi-asserted-by":"publisher","DOI":"10.1016\/S0399-8320(04)95183-4"}],"container-title":["Tumori Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/030089160709300509","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/030089160709300509","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:29:30Z","timestamp":1777660170000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/030089160709300509"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,9]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2007,9]]}},"alternative-id":["10.1177\/030089160709300509"],"URL":"https:\/\/doi.org\/10.1177\/030089160709300509","relation":{},"ISSN":["0300-8916","2038-2529"],"issn-type":[{"value":"0300-8916","type":"print"},{"value":"2038-2529","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,9]]}}}