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Non-small-bowel lesions encountered during double-balloon enteroscopy performed for obscure gastrointestinal bleeding

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World Journal of Gastroenterology 2010年第15期16卷 1885-1889页

作者： Hoi-Poh Tee Arthur J Kaffes A W Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital

AIM:To report the incidence of non-small-bowel bleeding pathologies encountered during double-balloon enteroscopy (DBE) procedures and to analyse their ***: A retrospective study of a prospective DBE database conducted in a tertiary-referral center was conducted. A total of 179 patients with obscure gastrointestinal bleeding (OGIB) referred for DBE from June 2004 to November 2008 were analysed looking for the incidence of non-small-bowel lesions (NSBLs; all and newly diagnosed) encountered during ***: There were 228 (150 antegrade and 78 retrograde) DBE procedures performed in 179 patients. The mean number of DBE procedures was 1.27 per patient. The mean age (SD) of the patients was 62 ± 16 years old. There were 94 females (52.5%). The positive yield for a bleeding lesion was 65.9%. Of the 179 patients, 44 (24.6%) had NSBLs (19 of them had dual pathology with small-bowel lesions and NSBLs); 27 (15.1%) had lesions not detected by previous endoscopies. The most common type of missed lesions were vascular ***: A significant proportion of patients (24.6%) had lesions within reach of conventional endoscopy. Careful repeat examination with gastroscopy and colonoscopy might be required.

关键词： bleeding obscure gastrointestinal bleeding Endoscopy Double-balloon enteroscopy

Single-center experience of 309 consecutive patients with obscure gastrointestinal bleeding

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World Journal of Gastroenterology 2009年第45期15卷 5740-5745页

作者： Bing-Ling Zhang You-Hong Fang Chun-Xiao Chen You-Ming Li Zun Xiang Department of Gastroenterology The First Affiliated Hospital College of Medicine Zhejiang University Hangzhou 310003 Zhejiang Province China The Children's Hospital College of MedicineZhejiang University 57 Zhugan Lane Yanan Road Hangzhou 310003 Zhejiang Province China

AIM: To investigate the diagnostic yield of capsule endoscopy (CE) in patients with obscure gastrointestinal bleeding (OGIB), and to determine whether the yield was affected by different bleeding status. METHODS: Three hundred and nine consecutive patients (all with recent negative gastric and colonic endoscopy results) were investigated with CE; 49 cases with massive bleeding and 260 cases with chronic recurrent overt bleeding. Data regarding OGIB were obtained by retrospective chart review and review of an internal database of CE fi ***: Visualization of the entire small intestine was achieved in 81.88% (253/309) of cases. Clinically positive findings occurred in 53.72% (166/309) of cases. The positivity of the massive bleeding group was slightly higher than that of the chronic recurrent overt bleeding group but there was no significant difference (59.18% vs 52.69%, P > 0.05) between the two groups. Small intestinal tumors were the most common fi nding in the entire cohort, these accounted for 30% of clinically signifi cant lesions. In the chronic recurrent overt bleeding group angioectasia incidence reached more than 29%, while in the massive bleedinggroup, small intestinal tumors were the most common finding at an incidence of over 51%. Increasing patient age was associated with positive diagnostic yield of CE and the findings of OGIB were different according to age range. Four cases were compromised due to the capsule remaining in the stomach during the entire test, and another patient underwent emergency surgery for massive bleeding. Therefore, the complication rate was 1.3%. CONCLUSION: In this study CE was proven to be a safe, comfortable, and effective procedure, with a high rate of accuracy for diagnosing OGIB.

关键词： obscure gastrointestinal bleeding Capsule endoscopy Massive bleeding Chronic recurrent overt occult bleeding

Double-balloon enteroscopy for obscure gastrointestinal bleeding: A single center experience in China

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World Journal of Gastroenterology 2010年第13期16卷 1655-1659页

作者： Chen, Li-Hua Chen, Wen-Guo Cao, Hai-Jun Zhang, Hong Shan, Guo-Dong Li, Lin Zhang, Bing-Ling Xu, Cheng-Fu Ding, Kai-Li Fang, Ying Cheng, Ying Wu, Chen-Jiao Xu, Guo-Qiang Zhejiang Univ Dept Gastroenterol Affiliated Hosp 1 Coll Med Hangzhou 310003 Zhejiang Peoples R China Zhejiang Univ Chinese Med Dept Gastroenterol Affiliated Hosp 1 Hangzhou 310003 Zhejiang Peoples R China Dongyang Peoples Hosp 1 Dept Gastroenterol Jinhua 322100 Zhejiang Peoples R China Zhejiang Univ Dept Endoscopy Ctr Affiliated Hosp 1 Coll Med Hangzhou 310003 Zhejiang Peoples R China

AIM: To evaluate the diagnostic value of double-balloon enteroscopy (DBE) for obscure gastrointestinal bleeding (OGIB). METHODS: The data about 75 OGIB patients who underwent DBE in January 2007-June 2009 in our hospital were retrospectively analyzed. RESULTS: DBE was successfully performed in all 75 patients without complication. Of the 75 patients, 44 (58.7%) had positive DBE findings, 22 had negative DBE findings but had potential bleeding at surgery and capsule endoscopy, etc . These 66 patients were finally diagnosed as OGIB which was most commonly caused by small bowel tumor (28.0%), angiodysplasia (18.7%) and Crohn’s disease (10.7%). Lesions occurred more frequently in proximal small bowel than in distal small bowel (49.3% vs 33.3%, P = 0.047). CONCLUSION: DBE is a safe, effective and accurate procedure for the diagnosis of OGIB.

关键词： Double-balloon enteroscopy Capsule endoscopy obscure gastrointestinal bleeding Diagnosis

Implications of small-bowel transit time in the detection rate of capsule endoscopy: A multivariable multicenter study of patients with obscure gastrointestinal bleeding

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World Journal of Gastroenterology 2017年第4期23卷 697-702页

作者： Carlo Maria Girelli Marco Soncini Emanuele Rondonotti Gastroenterology and Digestive Endoscopy Unit Hospital of Busto Arsizio(VA) Gastroenterology S.Carlo Hospital Gastroenterology Valduce Hospital

AIMTo define the role of small-bowel transit time in the detection rate of significant small-bowel ***-bowel capsule endoscopy records, prospectively collected from 30 participating centers in the Lombardy Registry from October 2011 to December 2013, were included in the study if the clinical indication was obscure gastrointestinal bleeding and the capsule reached the cecum. Based on capsule findings, we created two groups: P2 (significant findings) and P0-1 (normal/negligible findings). Groups were compared for age, gender, small-bowel transit time, type of instrument, modality of capsule performance (outpatients vs inpatients), bowel cleanliness, and center *** retrieved and scrutinized 1,433 out of 2,295 capsule endoscopy records (62.4%) fulfilling the inclusion criteria. Patients were 67 ± 15 years old, and 815 (57%) were males. In comparison with patients in the P0-1 group, those in the P2 group (n = 776, 54%) were older (P obscure gastrointestinal bleeding, a longer small-bowel transit time was associated with a higher detection rate of significant lesions, along with age and a low center volume, with age serving as an independent predictor.

关键词： Capsule endoscopy Small-bowel transit time Detection rate Diagnostic yield Small bowel obscure gastrointestinal bleeding Prokinetics Suspect small-bowel bleeding

Small-bowel mucosal injuries in low-dose aspirin users with obscure gastrointestinal bleeding

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World Journal of Gastroenterology 2014年第36期20卷 13133-13138页

作者： Junichi Iwamoto Yuji Mizokami Yoshifumi Saito Koichi Shimokobe Akira Honda Tadashi Ikegami Yasushi Matsuzaki Department of Gastroenterology Tokyo Medical University Ibaraki Medical Center Ibaraki 300-0395 Japan Department of Gastroenterology University of Tsukuba Ibaraki 305-8576 Japan

AIM: To investigate the clinical differences between small intestinal injuries in low-dose aspirin (LDA) users and in non-steroidal anti-inflammatory drug (NSAID) users who were examined by capsule endoscopy (CE) for ... 详细信息

关键词： Non-steroidal anti-inflammatory drugs Low-dose aspirin Small-bowel mucosal injuries obscure gastrointestinal bleeding Capsule endoscopy

Assessment of multi-modality evaluations of obscure gastrointestinal bleeding

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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 bleeding may benefit from proceeding directly to antegrade DBE.

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

Sarcomatoid carcinoma of the jejunum presenting as obscure gastrointestinal bleeding in a patient with a history of gliosarcoma

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Gastroenterology Report 2014年第2期2卷 150-153页

作者： Nidia Alfonso Puentes Carmen Jimenez-Alfaro Larrazabal Maria Isabel Garcia Higuera Clinical Neurophysiology Department Hospital Universitario de BurgosSpain Department of Internal Medicine Hospital Universitario de BurgosSpain Department of Pathology Hospital Universitario de BurgosSpain

Small bowel malignant tumors are rare and sarcomatoid carcinomas have rarely been reported at this *** report a 56-year-old woman,with history of an excised gliosarcoma,who presented with recurrent obscure gastrointestinal *** underwent endoscopy and colonoscopy,which failed to identify the cause of the *** abdominal computed tomography scan located a tumor in the small *** revealed a jejunal sarcomatoid *** developed tumor recurrence and multiple liver metastases shortly after *** is required for accurate *** carcinoma is a rare cause of obscure gastrointestinal bleeding,which is associated with a poor prognosis.

关键词： obscure gastrointestinal bleeding small bowel tumors sarcomatoid carcinoma

Capsule endoscopy and push enteroscopy in the diagnosis of obscure gastrointestinal bleeding

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Chinese Medical Journal 2004年第7期117卷 1045-1049页

作者：戈之铮胡运彪萧树东 Department of Gastroenterology

Background In obscure gastrointestinal (GI) bleeding, it is often difficult to detect the bleeding sites located in the small bowel with conventional radiological, scintigraphic or angiographic techniques. Push enteroscopy and capsule endoscopy are currently considered to be the most effective diagnostic procedures. The aim of this study was to compare the detection rates between capsule endoscopy and push enteroscopy. Methods From May 2002 through January 2003, we prospectively examined by capsule endoscopy 39 patients with suspected small bowel diseases, in particular GI bleeding of unknown origin in Renji Hospital. Among them, 32 complained of obscure recurrent GI bleeding. Between January 1993 and October 1996, we used push enteroscopy on 36 patients who suffered from unexplained GI bleeding. All patients had prior normal results on gastroscopy, colonoscopy, small bowel barium radiography, scintigraphy and/or angiography. Results M2A capsule endoscopy disclosed abnormal small bowel findings in 26 (82%) out of 32 patients. Twenty-one of them had significant pathological findings explaining their clinical disorders. Diagnostic yield was therefore 66% (21 of 32 patients). Definite bleeding sites diagnosed by capsule endoscopy in 21 patients included angiodysplasia (8), inflammatory small-bowel (5), small-bowel polyps (4), gastrointestinal stromal tumour (2), carcinoid tumour and lipoma (1), and hemorrhagic gastritis (1). Push enteroscopy detected the definite sources of bleeding in 9 (25%) of the 36 patients. Patients with definite bleeding sources included angiodysplasias (2), leiomyosarcoma (2), leiomyoma (1), lymphoma (1), Crohn’s disease (1), small-bowel polyps (1) and adenocarcinoma of ampulla (1). Suspected bleeding sources were shown by push enteroscopy in two additional patients (6%), and in other five patients (16%) by capsule endoscopy. Conclusions The present study of patients with obscure GI bleeding showed that capsule endoscopy significa

关键词： capsule endoscopy push enteroscopy obscure gastrointestinal bleeding

An Unusual Cause of obscure gastrointestinal bleeding Using an Abdominal CT Scan with Contrast: A Case Report of Small Intestinal GIST at the Duodenojejunal Junction

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Open Journal of Gastroenterology 2023年第11期13卷 351-358页

作者： Vithiarithy Chey Neang Nov Panha Uong Anan Chea Keoseyla Unn Vitou Leang Syphanna Sou gastrointestinal Department Khmer Soviet Friendship Hospital Phnom Penh Cambodia University of Health Sciences Phnom Penh Cambodia Loung Mè Hospital Phnom Penh Cambodia

Background/Aim: gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. However, they only constitute approximately 1% of all primary GI tumors. GISTs are most commonly found in the stomach (60% - 70%) and small intestine (20% - 30%). Colorectal (5%) and esophageal (Presentation of Clinical Case: A 33-year-old male, presented to the emergency department for melena and dizziness in January 2023. He was hospitalized several times for anemia with multiple blood transfusions since 2017 and never made a final diagnosis. From 2017 to 2019 he underwent esophagogastroduodenoscopy (EGD) and ileocolonoscopy 3 times which always gave a negative result. At this time, laboratory results showed microcytic anemia with hemoglobin 7 g/dl. We performed an EGD and ileocolonoscopy again but still showed negative then we did an abdominal CT scan with contrast with demonstrated a solid exophytic hypervascular mass measuring 62 × 38 × 73 mm that appeared to arise from the duodenojejunal junction. The surgeon decided to proceed with surgical resection of the mass and the histopathologist confirmed the diagnosis of GISTs. The patients were discharged in stable condition after the surgery and followed up every 3 - 6 months with the oncologist. Conclusion: The presentation of chronic GI bleeding with negative results in EGD and ileocolonoscopy, and abdominal CT scan with contrast could provide useful information in order to obtain a diagnosis of bleeding GISTS. Teamwork is the cornerstone in the management of the case. After the resection of the mass by the surgeon, the histopathologist allowed us to establish the definitive diagnosis and the oncologist will follow up with this patient in order to prevent the relapse of symptoms.

关键词： obscure gastrointestinal bleeding gastrointestinal Stromal Tumors gastrointestinal Endoscopy Histopathological Study Surgical Resection