Assessment of multi-modality evaluations of obscure gastrointestinal bleeding

作     者：Ryan Law Jithinraj E Varayil Louis M Wong Kee Song Jeff Fidler Joel G Fletcher John Barlow Jeffrey Alexander Elizabeth Rajan Stephanie Hansel Brenda Becker Joseph J Larson Felicity T Enders David H Bruining Nayantara Coelho-Prabhu 

作者机构：Division of Gastroenterology and HepatologyMayo Clinic Division of RadiologyMayo Clinic Division of Health Sciences ResearchMayo Clinic 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2017年第23卷第4期

页      面：614-621页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：加倍汽球 enteroscopy 计算断层摄影术 enterography 录像囊 enteroscopy 遮住胃肠的流血 

摘      要：AIM To determine the frequency of bleeding source detection in patients with obscure gastrointestinal bleeding(OGIB) who underwent double balloon enteroscopy(DBE) after pre-procedure imaging [multiphase computed tomography enterography(MPCTE), video capsule endoscopy(VCE), or both] and assess the impact of imaging on DBE diagnostic *** Retrospective cohort study using a prospectively maintained database of all adult patients presenting with OGIB who underwent DBE from September 1^(st), 2002 to June 30^(th), 2013 at a single tertiary *** Four hundred and ninety five patients(52% females; median age 68 years) underwent DBE for OGIB. AVCE and/or MPCTE performed within 1 year prior to DBE(in 441 patients) increased the diagnostic yield of DBE(67.1% with preceding imaging vs 59.5% without). Using DBE as the gold standard, VCE and MPCTE had a diagnostic yield of 72.7% and 32.5% respectively. There were no increased odds of finding a bleeding site at DBE compared to VCE(OR = 1.3, P = 0.150). There were increased odds of finding a bleeding site at DBE compared to MPCTE(OR = 5.9, P 0.001). In inpatients with overt OGIB, diagnostic yield of DBE was not affected by preceding *** DBE is a safe and well-tolerated procedure for the diagnosis and treatment of OGIB, with a diagnostic yield that may be increased after obtaining a preceding VCE or MPCTE. However, inpatients with active ongoing bleeding may benefit from proceeding directly to antegrade DBE.