title: Push enteroscopy for gastrointestinal bleeding: diagnostic yield and long-term follow-up.
abstract: OBJECTIVE
  Little is known about the long-term course of patients explored by push enteroscopy for gastrointestinal bleeding of obscure origin. This study aimed to determine the diagnostic yield and the therapeutic impact of enteroscopy, the rate of rebleeding and predictive factors of rebleeding in these patients.
  
  
  METHODS
  One hundred nineteen patients underwent push enteroscopy for overt bleeding (N=66) or anemia (N=53).
  
  
  RESULTS
  Enteroscopy was positive in 42% of patients (colon 17%, stomach 13%, small bowel 12%) and diagnosed arteriovenous malformations in two-thirds of patients. Twenty-five additional diagnoses were established during the 2-month follow-up. Treatment was definitive in 13% of patients, without recurrent bleeding. Rebleeding occurred in 45% of patients, and was more frequent when a lesion was visualized (73% vs 28% after 5 years, P=0.02). In multivariate analysis, a lesion visualized by enteroscopy was the only independent predictive factor.
  
  
  CONCLUSIONS
  Enteroscopy is not a high-performance diagnostic tool for obscure gastrointestinal bleeding and enables definitive treatment in less than 15% of patients.
authors.affiliation: Service d'Hépato-Gastroentérologie, CHU de Nantes, Hôtel-Dieu, 44093 Nantes Cedex.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Romelaer
authors.forename: Marc
authors.initials: M
authors.lastname: Le Rhun
authors.forename: Laurent
authors.initials: L
authors.lastname: Beaugerie
authors.forename: Jérôme
authors.initials: J
authors.lastname: Gournay
authors.forename: Claude
authors.initials: C
authors.lastname: Masliah
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Coron
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Galmiche
authors.forename: Stanislas
authors.initials: S
authors.lastname: Bruley Des Varannes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003663:Decision Trees; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors