Double-balloon enteroscopy in patients with GI bleeding of obscure origin.
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.
Manabe
Noriaki
N
Department of Endoscopy, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Tanaka
Shinji
S
Fukumoto
Akira
A
Nakao
Madoka
M
Kamino
Daisuke
D
Chayama
Kazuaki
K
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