title: Long-term outcomes after single-balloon enteroscopy in patients with obscure gastrointestinal bleeding.
abstract: BACKGROUND
  Limited data exists on the long-term outcomes of patients with obscure gastrointestinal bleeding (OGIB) following single-balloon enteroscopy (SBE).
  
  
  OBJECTIVE
  To examine the long-term outcomes of patients undergoing SBE for OGIB.
  
  
  METHODS
  Consecutive patients undergoing SBE for OGIB at a tertiary care center between 2008 and 2010 were retrospectively identified. Clinical data and SBE findings were extracted from the medical record. Recurrence of OGIB during follow-up through 2012 was assessed by a combination of chart review and telephone interviews.
  
  
  RESULTS
  One hundred and forty-seven patients were included in the study. The overall diagnostic yield of SBE was 64.6% (95/147 patients). Findings of SBE included vascular lesions (VLs, 53.7%), small bowel neoplasm (2.7%), inflammatory lesions (4.8%), and normal SBE (35.4%). One hundred and ten patients (56.4% female, mean age 70.6±11.3 years) were followed for an average 23.9 months after initial SBE. During follow-up, OGIB recurred in 39.5% of patients in whom a source of OGIB was identified on SBE and 55.9% of patients with normal findings on SBE. OGIB recurred in 47.6% of patients in whom small bowel VLs were treated endoscopically. None of the 13 patients in whom a non-VL lesion was identified as the source of bleeding on SBE experienced recurrent bleeding (p=0.019).
  
  
  CONCLUSIONS
  SBE is a safe and valuable method for managing patients with OGIB. More than 50% of patients experienced no recurrent bleeding during 2 years of follow-up after SBE. The long-term management of OGIB due to small bowel VLs remains challenging.
authors: Division of Gastroenterology, Department of Internal Medicine, Washington University School of Medicine, 660 South Euclid Ave, Campus Box 8124, St. Louis, MO 63110, USA.
authors: Vladimir M
authors: VM
authors: Kushnir
authors: Michael
authors: M
authors: Tang
authors: Johnathan
authors: J
authors: Goodwin
authors: Thomas G
authors: TG
authors: Hollander
authors: Christine E
authors: CE
authors: Hovis
authors: Faris M
authors: FM
authors: Murad
authors: Daniel K
authors: DK
authors: Mullady
authors: Riad R
authors: RR
authors: Azar
authors: Sreenivasa S
authors: SS
authors: Jonnalagadda
authors: Dayna S
authors: DS
authors: Early
authors: Steven A
authors: SA
authors: Edmundowiz
authors: Chien-Huan
authors: CH
authors: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome