title: Clinical outcome after enteroscopy for small bowel angioectasia bleeding: A Korean Associateion for the Study of Intestinal Disease (KASID) multiceter study.
abstract: OBJECTIVE
  Angioectasias are the most common sources of bleeding in the small bowel. They can be treated using balloon-assisted enteroscopy (BAE). This study aimed to identify the rebleeding rate and associated factors after BAE in patients with small bowel angioectasia bleeding.
  
  
  METHODS
  We retrospectively analyzed the records of patients with bleeding due to small bowel vascular lesion in a multicenter enteroscopy database including 1108 BAEs. Finally, in rebleeding analysis, we analyzed 66 patients with angioectasia on the basis of the Yano-Yamamoto classification. Patients who had undergone endotherapy (ET) were divided into ET (n = 45) and non-ET (n = 21) groups. Rebleeding was defined as evidence of bleeding at least 30 days after BAE.
  
  
  RESULTS
  Fifty-three patients (80.4%) underwent only one-side enteroscopy. The most common ET was argon plasma coagulation (87.2%). During a mean follow-up duration of 24.5 months, ET and non-ET groups had rebleeding rates of 15.6% and 38.1% (P = 0.059), respectively. Median rebleeding time of ET and non-ET groups was 32.5 and 62 months, respectively. Liver cirrhosis (LC), low platelet count (< 105/μL), and transfusions were the rebleeding-associated factors in the univariate analysis. In the multivariate analysis, the presence of LC (HR 4.064, 95% CI 1.098-15.045; P = 0.036) was the only independent rebleeding-associated risk factor.
  
  
  CONCLUSIONS
  ET using BAE did not significantly affect the rebleeding rate in patients with small bowel angioectasia bleeding. An independent rebleeding risk factor was the presence of LC. Regardless of ET, careful long-term follow-up may be needed, especially in LC patients with small bowel angioectasia bleeding.
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Seong Ran
authors.initials: SR
authors.lastname: Jeon
authors.affiliation: University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
authors.affiliation: Hallym University College of Medicine, Hwasung, Korea.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Jang
authors.affiliation: Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Soo Jung
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea.
authors.forename: Jong Pil
authors.initials: JP
authors.lastname: Im
authors.affiliation: Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Eun Ran
authors.initials: ER
authors.lastname: Kim
authors.affiliation: Korea University College of Medicine, Ansan, Korea.
authors.forename: Ja Seol
authors.initials: JS
authors.lastname: Koo
authors.affiliation: Soonchunhyang University College of Medicine, Bucheon, Korea.
authors.forename: Bong Min
authors.initials: BM
authors.lastname: Ko
authors.affiliation: Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Dong Kyung
authors.initials: DK
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Jin-Oh
authors.initials: JO
authors.lastname: Kim
authors.affiliation: Biostatistical Consulting Unit, Soonchunhyang University Medical Center, Seoul, Korea.
authors.forename: Su Yeon
authors.initials: SY
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000071087:Balloon Enteroscopy / Q000009:adverse effects; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D007421:Intestine, Small / Q000601:surgery*; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: balloon-assisted enteroscopy; endotherapy; obscure gastrointestinal bleeding; rebleeding