Urgent double balloon endoscopy provides higher yields than non-urgent double balloon endoscopy in overt obscure gastrointestinal bleeding

Aniwan, Satimai; Viriyautsahakul, Vichai; Rerknimitr, Rungsun; Angsuwatcharakon, Phonthep; Kongkam, Pradermchai; Treeprasertsuk, Sombat; Kullavanijaya, Pinit

doi:10.1055/s-0034-1365543

Cited by 38 publications

(47 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent study reported a high diagnostic and therapeutic yield (90%) with early (within 24 hours) DBE 83 in 10 patients with overt small-bowel bleeding. Another retrospective study 84 showed a higher diagnostic yield and lower incidence of recurrent bleeding with urgent DBE (within 72 hours after the last visible GI bleeding) compared with non-urgent DBE (diagnostic yield of 70% vs 30%; P < .05) in 120 patients with obscure smallbowel bleeding. These studies suggest that early intervention with DBE may yield better outcomes.…”

Section: Role Of Vcementioning

confidence: 97%

The role of endoscopy in the management of suspected small-bowel bleeding

Gurudu¹,

Bruining²,

Acosta³

et al. 2017

Gastrointestinal Endoscopy

130

View full text Add to dashboard Cite

show abstract

Section: Role Of Vcementioning

confidence: 97%

The role of endoscopy in the management of suspected small-bowel bleeding

Gurudu¹,

Bruining²,

Acosta³

et al. 2017

Gastrointestinal Endoscopy

130

View full text Add to dashboard Cite

show abstract

“…However, a small recent study actually suggests that emergency DBE is technically feasible and may facilitate the diagnosis and management of patients with massive overt small bowel hemorrhage ( 90 ). A more recent study also suggests that urgent DBE is better than non-urgent DBE and is associated with a lower recurrent bleeding rate ( 91 ). In addition, one study suggests that repeat DBE from the same direction may also be benefi cial, particularly if the patient had a prior positive DBE ( 92 ).…”

Section: Endoscopic Visualization Of the Small Intestinementioning

confidence: 99%

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding

Gerson

Fidler

Cave³

et al. 2015

American Journal of Gastroenterology

584

559

View full text Add to dashboard Cite

Bleeding from the small intestine remains a relatively uncommon event, accounting for ~5-10% of all patients presenting with gastrointestinal (GI) bleeding. Given advances in small bowel imaging with video capsule endoscopy (VCE), deep enteroscopy, and radiographic imaging, the cause of bleeding in the small bowel can now be identified in most patients. The term small bowel bleeding is therefore proposed as a replacement for the previous classification of obscure GI bleeding (OGIB). We recommend that the term OGIB should be reserved for patients in whom a source of bleeding cannot be identified anywhere in the GI tract. A source of small bowel bleeding should be considered in patients with GI bleeding after performance of a normal upper and lower endoscopic examination. Second-look examinations using upper endoscopy, push enteroscopy, and/or colonoscopy can be performed if indicated before small bowel evaluation. VCE should be considered a first-line procedure for small bowel investigation. Any method of deep enteroscopy can be used when endoscopic evaluation and therapy are required. VCE should be performed before deep enteroscopy if there is no contraindication. Computed tomographic enterography should be performed in patients with suspected obstruction before VCE or after negative VCE examinations. When there is acute overt hemorrhage in the unstable patient, angiography should be performed emergently. In patients with occult hemorrhage or stable patients with active overt bleeding, multiphasic computed tomography should be performed after VCE or CTE to identify the source of bleeding and to guide further management. If a source of bleeding is identified in the small bowel that is associated with significant ongoing anemia and/or active bleeding, the patient should be managed with endoscopic therapy. Conservative management is recommended for patients without a source found after small bowel investigation, whereas repeat diagnostic investigations are recommended for patients with initial negative small bowel evaluations and ongoing overt or occult bleeding.

show abstract

“…The lesion-specific diagnostic yield for emergency CE reported by different authors ranged between 60 and 73.3%, with only fresh blood without identifiable lesions detected in 6.7–27% of cases. 2 , 11 , 12 Vascular lesions are the most common finding but ulcers and tumours ( Fig. 2 ) have also been reported.…”

Section: Emergency Capsule Endoscopymentioning

confidence: 99%

“…Emergency DAE has been defined by different authors as performance within 24–72 h of clinical presentation. 3 , 11 Severe OOGIB has been widely described as that occurring with haemodynamic instability and transfusion requirements.…”

Section: Conceptsmentioning

confidence: 99%

The Role of Emergency Endoscopy in Small Bowel Bleeding: A Review

Pérez-Cuadrado-Robles¹,

Pérez-Cuadrado-Martínez²

2016

GE Portuguese Journal of Gastroenterology

View full text Add to dashboard Cite

There is no consensus on the timing and management of emergency overt obscure gastrointestinal bleeding. Emergency capsule endoscopy and balloon-assisted enteroscopy have a high diagnostic and therapeutic yield in these situations. Most lesions detected by small bowel endoscopy are amenable to endoscopic haemostasis, although some lesions still require surgery or interventional radiology. The management of these patients is varied, and doubt persists about which technique should be preferred as first-line treatment. This narrative review analyses the usefulness and impact of small bowel endoscopic techniques in the emergency setting for severe overt obscure gastrointestinal bleeding.

show abstract

Urgent double balloon endoscopy provides higher yields than non-urgent double balloon endoscopy in overt obscure gastrointestinal bleeding

Cited by 38 publications

References 20 publications

The role of endoscopy in the management of suspected small-bowel bleeding

The role of endoscopy in the management of suspected small-bowel bleeding

ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding

The Role of Emergency Endoscopy in Small Bowel Bleeding: A Review

Contact Info

Product

Resources

About