Obscure gastrointestinal bleeding: diagnostic performance of 64-section multiphase CT enterography and CT angiography compared with capsule endoscopy

He, Baorong; Gong, Shenchu; Hu, Cao; Fan, Jingli; Qian, Jingjing; Huang, Shaobin; Cui, Lixia; Ji, Yang

doi:10.1259/bjr.20140229

Cited by 33 publications

(24 citation statements)

References 31 publications

(46 reference statements)

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“…) and ischemic enteritis . The diagnostic yields of cross‐sectional imaging for OGIB in previous studies were 17–48% …”

Section: Diagnosismentioning

confidence: 95%

Management of obscure gastrointestinal bleeding: Comparison of guidelines between Japan and other countries

Ohmiya

2019

Digestive Endoscopy

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Small‐bowel bleeding accounts for the majority of obscure gastrointestinal bleeding, but it is caused by various types of small bowel disease, upper gastrointestinal disease, and colorectal disease. For the diagnosis, history taking and physical examination are required, leading to a determination of what diseases are involved. Next, cross‐sectional imaging, such as computed tomography, should be carried out, followed by the latest enteroscopy such as small bowel capsule endoscopy and deep enteroscopy according to the severity of hemorrhage and patient condition. After a comprehensive diagnosis, medical, enteroscopic, or surgical treatment should be selected. This article reviews recent advances in the endoscopic diagnosis of obscure gastrointestinal bleeding and compares perspectives of the management of obscure gastrointestinal bleeding in Japan with that in other countries.

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“…) and ischemic enteritis . The diagnostic yields of cross‐sectional imaging for OGIB in previous studies were 17–48% …”

Section: Diagnosismentioning

confidence: 95%

Management of obscure gastrointestinal bleeding: Comparison of guidelines between Japan and other countries

Ohmiya

2019

Digestive Endoscopy

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“…When dynamic or enhanced helical CT detects wall thickness or strictures in the small bowel with proximal luminal dilatation, deep enteroscopy should be carried out for further investigation instead of VCE. Yields of cross‐sectional imaging for OGIB in the previous literature are shown in Table …”

Section: Diagnosismentioning

confidence: 99%

“…Yields of cross-sectional imaging for OGIB in the previous literature are shown in Table 2. [23][24][25][26][27][28][29][30]…”

Section: Cross-sectional Imagingmentioning

confidence: 99%

Obscure gastrointestinal bleeding: Diagnosis and treatment

Ohmiya

Nakagawa

Nagasaka

et al. 2015

Digestive Endoscopy

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Small-bowel bleeding comprises a majority of obscure gastrointestinal bleeding, but is caused by various kinds of diseases. For its diagnosis, history-taking and physical examination is requisite, leading to a suspicion of what diseases are involved. Next, cross-sectional imaging such as computed tomography should be done, followed by the latest enteroscopy, videocapsule endoscopy and deep enteroscopy according to the severity of hemorrhage and patient conditions. After comprehensive diagnosis, medical, enteroscopic, or surgical treatment should be selected.

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“…Firstly, strictures, stenosis, and luminal masses can lead to capsule retention and surgery may be required to remove the trapped capsule . Secondly, lesions lacking mucosal features such as stromal tumors may be missed by CE . Thirdly, CE has lower detection rates for lesions in the duodenum and proximal jejunum owing to short transit times in these areas .…”

Section: Introductionmentioning

confidence: 99%

“…CTE is an attractive alternative due to its lower costs, greater accessibility, and ability to identify space‐occupying, hyper‐vascular areas and extra‐luminal lesions of the abdomen . Furthermore, CTE has been shown to provide a greater diagnostic yield compared to CE for small bowel tumors …”

Section: Introductionmentioning

confidence: 99%

History of malignancy and relevant symptoms may predict a positive computed tomography enterography in obscure gastrointestinal bleeds

Leung

Zhang

McCurdy

et al. 2019

J of Gastro and Hepatol

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Background and Aim This study aimed to assess the clinical utility of computed tomography enterography (CTE) and identify factors associated with a diagnostic CTE for patients with obscure gastrointestinal bleeding (OGIB). Methods A retrospective observational study was performed at a Canadian tertiary care center from 2005 to 2015. A total of 138 patients underwent a CTE for OGIB. Univariate and multivariate logistic regressions were performed to determine factors associated with a diagnostic CTE. A highly sensitive clinical rule was then developed to help identify OGIB patients for whom a CTE may be beneficial in their clinical work‐up. Results A possible bleeding source was identified in 30 (22%) cases. The presence of abdominal or constitutional symptoms as well as history of colorectal cancer was significantly associated with a positive CTE in univariate and multivariate analyses (P < 0.05). A positive CTE could be predicted based on the presence of abdominal or constitutional symptoms and history of colorectal cancer with 90% sensitivity (95% CI 74–98%) in our population. Conclusion CTE identified a possible source of OGIB in one in five cases. In patients with the presence of abdominal or constitutional symptoms and a personal history of colorectal cancer, CTE may contribute to their diagnostic work‐up.

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Obscure gastrointestinal bleeding: diagnostic performance of 64-section multiphase CT enterography and CT angiography compared with capsule endoscopy

Cited by 33 publications

References 31 publications

Management of obscure gastrointestinal bleeding: Comparison of guidelines between Japan and other countries

Management of obscure gastrointestinal bleeding: Comparison of guidelines between Japan and other countries

Obscure gastrointestinal bleeding: Diagnosis and treatment

History of malignancy and relevant symptoms may predict a positive computed tomography enterography in obscure gastrointestinal bleeds

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