Long-term outcomes after single-balloon enteroscopy in patients with obscure gastrointestinal bleeding

Vladimir M. Kushnir, Michael Tang, Johnathan Goodwin, Thomas G. Hollander, Christine E. Hovis, Faris M. Murad, Daniel K. Mullady, Riad R. Azar, Sreenivasa S. Jonnalagadda, Dayna S. Early, Steven A. Edmundowiz, Chien Huan Chen

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25 Scopus citations

Abstract

Background: Limited data exists on the long-term outcomes of patients with obscure gastrointestinal bleeding (OGIB) following single-balloon enteroscopy (SBE). Aim: To examine the long-term outcomes of patients undergoing SBE for OGIB. Methods: Consecutive patients undergoing SBE for OGIB at a tertiary care center between 2008 and 2010 were retrospectively identified. Clinical data and SBE findings were extracted from the medical record. Recurrence of OGIB during follow-up through 2012 was assessed by a combination of chart review and telephone interviews. Results: One hundred and forty-seven patients were included in the study. The overall diagnostic yield of SBE was 64.6 % (95/147 patients). Findings of SBE included vascular lesions (VLs, 53.7 %), small bowel neoplasm (2.7 %), inflammatory lesions (4.8 %), and normal SBE (35.4 %). One hundred and ten patients (56.4 % female, mean age 70.6 ± 11.3 years) were followed for an average 23.9 months after initial SBE. During follow-up, OGIB recurred in 39.5 % of patients in whom a source of OGIB was identified on SBE and 55.9 % of patients with normal findings on SBE. OGIB recurred in 47.6 % of patients in whom small bowel VLs were treated endoscopically. None of the 13 patients in whom a non-VL lesion was identified as the source of bleeding on SBE experienced recurrent bleeding (p = 0.019). Conclusions: SBE is a safe and valuable method for managing patients with OGIB. More than 50 % of patients experienced no recurrent bleeding during 2 years of follow-up after SBE. The long-term management of OGIB due to small bowel VLs remains challenging.

Original languageEnglish
Pages (from-to)2572-2579
Number of pages8
JournalDigestive diseases and sciences
Volume58
Issue number9
DOIs
StatePublished - Sep 2013

Keywords

  • Adult
  • Endoscopy, gastrointestinal/methods
  • Follow-up studies
  • Gastrointestinal hemorrhage/diagnosis
  • Gastrointestinal hemorrhage/therapy
  • Intestine, small
  • Treatment outcomes

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