Document Detail


Long-term outcome of patients with obscure gastrointestinal bleeding investigated by double-balloon endoscopy.
MedLine Citation:
PMID:  19879968     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: It is often difficult to determine the cause of obscure gastrointestinal bleeding (OGIB). We evaluated the diagnostic yield and long-term outcome of patients with OGIB by using double-balloon endoscopy (DBE).
METHODS: In this large, retrospective cohort study, DBE was performed in 200 consecutive patients with OGIB. Follow-up data were available from 151 patients for 29.7 months (range, 6-78 months), and clinical outcome was assessed.
RESULTS: DBE detected bleeding sources in 155 of 200 patients (77.5%). The most frequent source detected was small intestine ulcers/erosions (64 patients). Patients who underwent DBE within 1 month after the last episode of overt bleeding had a better yield of positive findings than those who did not (84%, 107/128 patients vs 57%, 24/42; P = .002). The overall rate of control of OGIB was 64% (97/151 patients). Patients with vascular lesions of the small intestine had a significantly lower rate of control of OGIB than those with other small intestine lesions (40%, 12/30 patients vs 74%, 52/70; P = .001). A requirement for a large transfusion before DBE (P = .012), multiple lesions (P = .010), and suspicious (not definite) lesions (P = .038) each significantly increased the likelihood of overt rebleeding in patients with vascular lesions of the small intestine.
CONCLUSIONS: DBE is useful for the diagnosis of patients with OGIB and should be performed as soon as possible after overt OGIB. Patients with vascular lesions of the small intestine should be followed with particular care.
Authors:
Satoshi Shinozaki; Hironori Yamamoto; Tomonori Yano; Keijiro Sunada; Tomohiko Miyata; Yoshikazu Hayashi; Masayuki Arashiro; Kentaro Sugano
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Publication Detail:
Type:  Journal Article     Date:  2009-10-30
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  8     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-15     Completed Date:  2010-04-21     Revised Date:  2011-02-02    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  151-8     Citation Subset:  IM    
Copyright Information:
Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Tochigi, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Cohort Studies
Endoscopy, Gastrointestinal / methods*
Female
Follow-Up Studies
Gastrointestinal Hemorrhage / diagnosis*,  surgery*
Humans
Male
Middle Aged
Retrospective Studies
Treatment Outcome
Young Adult
Comments/Corrections
Comment In:
Gastroenterology. 2010 Dec;139(6):2215-7; discussion 2217   [PMID:  20970448 ]
Endoscopy. 2011 Jan;43(1):38-41   [PMID:  21108176 ]

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