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

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.