title: Clinical impact of multidetector computed tomography before double-balloon enteroscopy for obscure gastrointestinal bleeding.
abstract: OBJECTIVE
  To evaluate the clinical impact of multidetector computed tomography (MDCT) before double-balloon endoscopy (DBE) for patients with obscure gastrointestinal bleeding (OGIB).
  
  
  METHODS
  A retrospective analysis of prospectively collected cases with DBE and MDCT for overt OGIB was conducted from April 2004 to April 2010 at Changhua Christian Hospital. We evaluated the clinical impact of MDCT on the subsequent DBE examinations and the diagnostic yields of both MDCT and DBE respectively.
  
  
  RESULTS
  From April 2004 to April 2010, a total of 75 patients underwent DBE for overt OGIB. Thirty one cases received MDCT followed by DBE for OGIB. The overall diagnostic yields of DBE and MDCT was 93.5% and 45.2%. The MDCT had a high diagnostic yield of tumor vs non-tumor etiology of OGIB (85.7% vs 33.3%, P = 0.014). Additionally, the choice of initial route of DBE was correct in those with a positive MDCT vs negative MDCT (100% vs 52.9%, P = 0.003).
  
  
  CONCLUSIONS
  This study suggests MDCT as a triage tool may identify patients who will benefit from DBE and aid the endoscopist in choosing the most efficient route.
authors.affiliation: Department of Gastroenterology, Endoscopy Center, Changhua Christian Hospital, 500 Changhua, Taiwan, China. 91646@cch.org.tw
authors.forename: Hsu-Heng
authors.initials: HH
authors.lastname: Yen
authors.forename: Yang-Yuan
authors.initials: YY
authors.lastname: Chen
authors.forename: Chia-Wei
authors.initials: CW
authors.lastname: Yang
authors.forename: Chi-Kuang
authors.initials: CK
authors.lastname: Liu
authors.forename: Maw-Soan
authors.initials: MS
authors.lastname: Soon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058582:Double-Balloon Enteroscopy / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications / Q000473:pathology; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D012189:Retrospective Studies