Three abstracts at Digestive Disease Week (DDW) 2003 reported the findings of intraoperative enteroscopy (IOE) in patients having previously undergone WCE that revealed lesions. IOE was negative in up to approximately 10% of cases (Katz et al, 2003; Hartmann et al, 2003; Wolff et al, 2003). Whether these are false positive WCE or false negative IOE remains to be determined. Obviously IOE is performed in a nonphysiologic state and lesions can be overlooked. A 10% false positive rate of WCE may be reasonable. Conversely, to our knowledge, there is no study in which patients with negative WCE and continued bleeding undergo IOE. This study may allow us to determine the false negative rate of WCE and refine its utility. Our current approach to patients with negative WCE, especially those younger than 40 years of age with severe OGIB, is early laparotomy and IOE as the frequency of small intestinal tumors and Meckel's diverticulum may be higher than those older than 40 years of age (Geller et al, 1993).
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