Long-Term Outcome after Double-Balloon Endoscopy in Patients with Obscure Gastrointestinal Bleeding

Abstract

Background and Aims: There are limited data concerning the clinical outcome of patients with obscure gastrointestinal bleeding (OGIB) after double-balloon endoscopy (DBE). The aim of the present study was to evaluate the long-term outcome of patients with OGIB after DBE. Patients and Methods: Eighty-seven consecutive patients with OGIB (47 men and 40 women; mean age 65.3 years) underwent DBE between July 2006 and December 2009. The criteria for assessment included documented iron deficiency anemia/occult or obscure small intestinal bleeding, and overt small intestinal bleeding. They were followed for a mean period of 41.4 months after DBE, and were divided into two groups according to their outcome, that is a good clinical course group (GC group) and a poor clinical course group (PC group). The clinical characteristics associated with rebleeding after DBE were analyzed by comparison of these two groups. Results: The source of bleeding was identified in 40 patients (46.0%) and endoscopic treatment was required in 21 of them (52.5%). The most frequent source of bleeding was ulcers/erosions (18.4%). During the follow-up period, 39 patients (44.8%) experienced bleeding and/or persistent iron deficiency anemia after DBE, while 48 patients did not. There were no significant differences of clinical characteristics between the two groups. However, there were more patients with diverticular bleeding in the GC group than the PC group, and there were significantly more patients with treatable small intestinal tumors/polyps in the GC group. There were also more patients with normal DBE findings in the GC group. Conclusion: This study demonstrated that the rebleeding rate after DBE varies depending on the source of bleeding.

Is Endoscopic Therapy Effective for Angioectasia in Obscure Gastrointestinal Bleeding?

“…17 Since then, another 375 studies have been published. These abstracts were reviewed, uncovering another 18 eligible manuscripts [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] reporting on rebleeding rates after endoscopic therapy for angioectasias ( Table 2). Combined with the 6 contained in the AGA technical review, 1 there were a total of 24 eligible endoscopic therapy outcomes papers.…”

Clinical Utility of Capsule Endoscopy and Double-Balloon Enteroscopy in the Management of Obscure Gastrointestinal Bleeding

“…If therapeutic DBE is successful, patients in clinically stable condition may be observed depending on the situation. Fujita et al [19] reported that the re-bleeding rate after DBE varied depending on the source of bleeding and patients with treatable lesions had good clinical outcomes after a follow-up period of 41.4 months. In contrast, further treatments such as angiography with interventional radiology or surgery should be considered in patients with evidence of persistent recurrent OGIB.…”

Usefulness of Double-Balloon Endoscopy in the Postoperative Gastrointestinal Tract

“…However, in Japan, Shinozaki et al [16] and Fujita et al [17] both reported that ulcerative lesions were common. In this paper, the result was 6 cases of vascular lesion, 5 cases of ulcerative lesions, and 1 case of neoplastic lesion.…”