Non-small-bowel lesions encountered during double-balloon enteroscopy performed for obscure gastrointestinal bleeding.
OBJECTIVE
To report the incidence of non-small-bowel bleeding pathologies encountered during double-balloon enteroscopy (DBE) procedures and to analyse their significance.


METHODS
A retrospective study of a prospective DBE database conducted in a tertiary-referral center was conducted. A total of 179 patients with obscure gastrointestinal bleeding (OGIB) referred for DBE from June 2004 to November 2008 were analysed looking for the incidence of non-small-bowel lesions (NSBLs; all and newly diagnosed) encountered during DBE.


RESULTS
There were 228 (150 antegrade and 78 retrograde) DBE procedures performed in 179 patients. The mean number of DBE procedures was 1.27 per patient. The mean age (SD) of the patients was 62 +/- 16 years old. There were 94 females (52.5%). The positive yield for a bleeding lesion was 65.9%. Of the 179 patients, 44 (24.6%) had NSBLs (19 of them had dual pathology with small-bowel lesions and NSBLs); 27 (15.1%) had lesions not detected by previous endoscopies. The most common type of missed lesions were vascular lesions.


CONCLUSIONS
A significant proportion of patients (24.6%) had lesions within reach of conventional endoscopy. Careful repeat examination with gastroscopy and colonoscopy might be required.
Tee
Hoi-Poh
HP
A W Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown Rd, Sydney 2050, Australia.
Kaffes
Arthur J
AJ
D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods; D015331:Cohort Studies; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies
Hepatogastroenterology. 2007 Apr-May;54(75):780-3
17591061
Gastrointest Endosc. 1998 May;47(5):372-6
9609429
Gastrointest Endosc. 2007 Aug;66(2):304-9
17643704
Gastrointest Endosc. 2001 Feb;53(2):216-20
11174299
Am J Gastroenterol. 1994 Dec;89(12):2143-6
7977230
Inflammopharmacology. 2007 Apr;15(2):74-7
17450446
J Clin Gastroenterol. 2008 Sep;42(8):962-3
18645532
Endoscopy. 1999 Aug;31(6):452-5
10494684
J Gastroenterol. 2008;43(2):93-9
18306982
Am J Gastroenterol. 2005 May;100(5):1058-64
15842579
Gastrointest Endosc. 2005 Aug;62(2):234-8
16046986
Gastroenterology. 2007 Nov;133(5):1697-717
17983812
Aliment Pharmacol Ther. 2009 Feb 1;29(3):342-9
19035975
Gastroenterology. 2004 Mar;126(3):643-53
14988816
Am J Surg. 1992 Jan;163(1):90-2; discussion 92-3
1733379
Gut. 1995 Sep;37(3):346-52
7590429
Endoscopy. 1995 Feb;27(2):164-70
7601049
Gastroenterology. 2000 Jan;118(1):201-21
10611170
Tech Vasc Interv Radiol. 2004 Sep;7(3):130-5
16015557