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Assessment of multi-modality evaluations of obscure gastrointestinal bleeding

World Journal of Gastroenterology 2017年第4期23卷 614-621页

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 Division of Gastroenterology and Hepatology Mayo Clinic Division of Radiology Mayo Clinic Division of Health Sciences Research Mayo Clinic

AIMTo 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 *** cohort study using a prospectively maintained database of all adult patients presenting with OGIB who underwent DBE from September 1st, 2002 to June 30th, 2013 at a single tertiary *** 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 *** 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.

关键词： Double balloon enteroscopy Computed tomography enterography Video capsule enteroscopy Obscure gastrointestinal bleeding

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