title: Double-balloon enteroscopy in patients with GI bleeding of obscure origin.
abstract: BACKGROUND
  Small-bowel bleeding is difficult to treat and diagnose. The recent introduction of wireless capsule endoscopy permits examination of the entire small intestine, but this method lacks tissue sampling and therapeutic capabilities. Recently, Yamamoto et al established a double-balloon insertion method for enteroscopy that allows examination of the entire small bowel and interventional options.
  
  
  OBJECTIVE
  To evaluate double-balloon enteroscopy in patients with obscure GI bleeding.
  
  
  METHODS
  Single-center prospective study.
  
  
  METHODS
  Thirty-one consecutive patients with obscure GI bleeding (13 females, 18 males; mean age 56.4 +/- 3.2 years). Criteria for inclusion in the study were documented iron deficiency anemia (hemoglobin level <10 g/dL or a decrease of >2 g/dL over > or =2 months); upper endoscopy not revealing a site/cause of blood loss; and similarly uninformative lower endoscopy including examination of the terminal ileum.
  
  
  METHODS
  Endoscopic biopsy or therapy was performed as clinically indicated.
  
  
  METHODS
  Diagnostic yield for patients with obscure GI bleeding and patient follow-up.
  
  
  RESULTS
  Double-balloon enteroscopy was completed without complications in all patients. Bleeding points were identified in 23 patients (74.2%). In 21 (91.3%) of these 23 patients the cause of blood loss was identified and treated with no further bleeding at 8.5 +/- 0.6 months of follow-up.
  
  
  CONCLUSIONS
  Small number of patients.
  
  
  CONCLUSIONS
  These data suggest that double-balloon enteroscopy is useful for evaluation and treatment of patients with GI bleeding of obscure origin.
authors.affiliation: Department of Endoscopy, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Manabe
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Akira
authors.initials: A
authors.lastname: Fukumoto
authors.forename: Madoka
authors.initials: M
authors.lastname: Nakao
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kamino
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology*; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis; D006391:Hemangioma / Q000175:diagnosis; D006801:Humans; D007580:Jejunal Neoplasms / Q000175:diagnosis; D016393:Lymphoma, B-Cell / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies