Gastroscopy: Advancing further into the horizontal part of the duodenum

Qiao, Wei; Ren, Yu; Liu, Si De; Zhi, Fa Chao

doi:10.1111/1751-2980.12434

Cited by 1 publication

(1 citation statement)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, with advancements in endoscopic devices and techniques, reaching the horizontal section of the duodenum with the endoscope has become feasible in recent years. In such cases, these lesions could be identified much earlier using upper GI endoscopy [ 36 , 37 ]. The identification of predictors for DL was not the focus of this study, as our aim was to elucidate the characteristics of DL through a case series.…”

Section: Discussionsupporting

confidence: 66%

Clinical characteristics of Dieulafoy’s lesion in the small bowel diagnosed and treated by double-balloon endoscopy

Nakamura,

Yamamura,

Maeda

et al. 2023

BMC Gastroenterol

View full text Add to dashboard Cite

Background Obscure gastrointestinal bleeding refers to bleeding for which the source cannot be ascertained even through balloon-assisted endoscopy. In certain instances, Dieulafoy’s lesion in the small bowel is presumed to be the underlying cause. Aim This retrospective study aimed to elucidate the clinical characteristics of Dieulafoy’s lesion in the small bowel as diagnosed via double-balloon endoscopy while also exploring the feasibility of predicting bleeding from Dieulafoy’s lesion prior to endoscopy in cases of obscure gastrointestinal bleeding. Methods A comprehensive analysis of our database was conducted, identifying 38 patients who received a diagnosis of Dieulafoy’s lesion and subsequently underwent treatment via double-balloon endoscopy. The clinical background, diagnosis, and treatment details of patients with Dieulafoy’s lesion were carefully examined. Results The median age of the 38 patients was 72 years, and 50% of the patients were male. A total of 26 (68%) patients exhibited a high comorbidity index. The upper jejunum and lower ileum were the most frequently reported locations for the occurrence of Dieulafoy’s lesion in the small bowel. The detected Dieulafoy’s lesions exhibited active bleeding (n = 33) and an exposed vessel with plaque on the surface (n = 5). Rebleeding after endoscopic treatment occurred in 8 patients (21%, median period: 7 days, range: 1-366 days). We conducted an analysis to determine the definitive nature of the initial double-balloon endoscopy diagnosis. Multivariate analysis revealed that hematochezia of ≥ 2 episodes constituted the independent factor associated with ≥ 2 double-balloon endoscopy diagnoses. Additionally, we explored factors associated with rebleeding following endoscopic treatment. Although the number of hemoclips utilized displayed a likely association, multivariate analysis did not identify any independent factor associated with rebleeding. Conclusion If a patient encounters multiple instances of hematochezia, promptly scheduling balloon-assisted endoscopy, equipped with optional instruments without delay is advised, after standard endoscopic evaluation with esophagogastroduodenoscopy and colonoscopy is unrevealing.

show abstract

Section: Discussionsupporting

confidence: 66%