Diagnostic yield of double-balloon endoscopy in patients with obscure GI bleeding

Indications, detectability, positive findings, total enteroscopy, and complications of diagnostic double-balloon endoscopy: a systematic review of data over the first decade of use

“…3,15,17,23 The potential explanation for this relatively high heterogeneity would be that there were different ratios of overt and occult small-bowel bleeding among the studies. Tanaka et al 25 reported that DBE detection rates for patients with overt-ongoing, overt-previous, and occult bleeding were 100.0%, 48.4%, and 42.1%, respectively, and the difference was statistically significant (P Ͻ .005). In the present study, vascular lesions, inflammatory lesions, and neoplastic lesions rank as the top 3 positive findings among patients with suspected mid-GI bleeding.…”

“…The inclusion of interventional procedures may explain the major difference between the two studies. In addition, 8 cases with aspiration pneumonia were collected in this review, and all of them were reported during antegrade DBE, 12,25,29,30 which indicates that antegrade DBE requiring sedation should always be conducted with close monitoring both during and after the procedure to prevent aspiration pneumonia or respiratory compromise. Based on the present study, perforation and pancreatitis are the most frequent major complications for diagnostic DBE and should be taken into consideration in written informed consent.…”

Route selection for double-balloon endoscopy, based on capsule transit time, in obscure gastrointestinal bleeding

“…Therefore, the route selection for DBE should be estimated by both the location of the lesion, detected by computed tomography (CT) or ultrasound sonography, and the distance from the mouth or anus to the lesion, as determined by VCE [35] or enteroclysis. In addition, it should be taken into consideration that DBE via the oral route tends to have more complications [7,36]. In the future, with more advanced diagnostic modalities, such as CT enterography and VCE, the distance of the whole small bowel and the distance to the lesion will be measured more accurately and any abdominal adhesions will be identified.…”

“…The advent of video capsule endoscopy (VCE) [3] and double-balloon endoscopy (DBE) [4] has enabled the observation of the whole small bowel and diagnosis of the hemorrhagic lesion. High sensitivity and specificity of these approaches for the diagnosis of OGIB has been reported [5][6][7]. Furthermore, DBE enables biopsy and therapeutic intervention [8,9].…”

The Role of Capsule Endoscopy, Balloon-Assisted Enteroscopy and Clinical Parameters in the Management of Patients with Obscure Gastrointestinal Bleeding

“…It is known that the diagnostic yields of both CE and BAE are highest when performed within a short interval of anemia, especially in case of overt OGIB [11,[29][30] . Considering the retrospective nature of this study, the management was not in a standardized manner and time between onset of bleeding and CE is not known.…”