Long-term outcome in patients with obscure gastrointestinal bleeding after negative capsule endoscopy

作     者：Seong-Joon Koh Jong Pil Im Ji Won Kim Byeong Gwan Kim Kook Lae Lee Sang Gyun Kim Joo Sung Kim Hyun Chae Jung 

作者机构：Department of Internal MedicineSeoul National University Boramae HospitalSeoul National University College of MedicineSeoul 110-744South Korea Department of Internal Medicine and Liver Research InstituteSeoul National University College of MedicineSeoul 110-744South Korea 

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

年 卷 期：2013年第19卷第10期

页      面：1632-1638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：Capsule endoscopy Gastrointestinal hemorrhage Risk factors Prognosis Enteroscopy 

摘      要：AIM:To investigate long-term outcome in obscure gastrointestinal bleeding(OGIB) after negative capsule endoscopy(CE) and identify risk factors for ***:A total of 113 consecutive patients underwent CE for OGIB from May 2003 to June 2010 at Seoul National University ***-five patients(84.1%) with a subsequent follow-up after CE of at least 6 mo were enrolled in this ***-up data were obtained from the patients medical *** CE images were reviewed by two board-certified gastroenterologists and consensus diagnosis was used in all *** primary outcome measure was the detection of rebleeding after CE,and factors associated with rebleeding were evaluated using multivariate ***:Of the 95 enrolled patients(median age 61 years,range 17-85 years),62 patients(65.3%) were *** median duration of follow-up was 23.7 mo(range 6.0-89.4 mo).Seventy-three patients(76.8%) underwent CE for obscure-overt *** examination of the small bowel was achieved in 77 cases(81.1%).Significant lesions were found in 38 patients(40.0%).The overall rebleeding rate was 28.4%.The rebleeding rate was higher in patients with positive CE(36.8%) than in those with negative CE(22.8%).However,there was no significant difference in cumulative rebleeding rates between the two groups(log rank test;P = 0.205).Anticoagulation after CE examination was an independent risk factor for rebleeding(hazard ratio,5.019;95%CI,1.560-16.145;P = 0.007),regardless of CE ***:Patients with OGIB and negative CE have a potential risk of ***,close observation is required and alternative modalities should be considered in suspicious cases.