Clinical features predicting the detection of abnormalities by double balloon endoscopy in patients with suspected small bowel bleeding.
OBJECTIVE
Although double balloon endoscopy (DBE) has demonstrated a high diagnostic yield in suspected small bowel bleeding, it is not known whether DBE is of equal value to all patients with suspected small bowel bleeding or of greater benefit in selected subgroups. We aimed to determine whether any clinical features predict an increased likelihood of finding a lesion in patients with suspected small bowel bleeding.


METHODS
We retrospectively analyzed clinical features of 43 consecutive patients (M : F = 26:17, age 13-82 years) who underwent DBE because of suspected small bowel bleeding. Data associated with DBE procedure were collected prospectively. Predictive factors for the detection of a lesion were determined by comparison of clinical features between patients with positive DBE findings and those with negative findings.


RESULTS
Potential bleeding sources were discovered in 30 patients (69.8%) out of 43. Duration of bleeding was longer in patients with positive DBE findings than in those with negative findings (195 +/- 311 vs 18 +/- 17 days, P = 0.015). Number of bleeding episodes was higher in patients with positive DBE findings (2.2 +/- 1.2 vs 1.3 +/- 0.5, P = 0.011). The odds ratio for the detection of bleeding focus on DBE for patients with two or more bleeding episodes, relative to those with only one current bleeding episode was 5.67 (95% CI: 1.12-28.81, P = 0.036) in multivariate analysis.


CONCLUSIONS
DBE may be the most useful in patients with suspected small bowel bleeding if they have a history of frequent bleeding episodes over a long period.
Byeon
Jeong-Sik
JS
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Chung
Jun-Won
JW
Choi
Kee Don
KD
Choi
Kwi-Sook
KS
Kim
Benjamin
B
Myung
Seung-Jae
SJ
Yang
Suk-Kyun
SK
Kim
Jin-Ho
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D007421:Intestine, Small / Q000473:pathology*; D007579:Jejunal Diseases / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors