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. 2014 Dec;2(6):490-6.
doi: 10.1177/2050640614554850.

Emergency single-balloon enteroscopy in overt obscure gastrointestinal bleeding: Efficacy and safety

Teresa Pinto-Pais  1 , Rolando Pinho  1 , Adélia Rodrigues  1 , Carlos Fernandes  1 , Iolanda Ribeiro  1 , José Fraga  1 , João Carvalho  1
Affiliations

Emergency single-balloon enteroscopy in overt obscure gastrointestinal bleeding: Efficacy and safety

Teresa Pinto-Pais et al. United European Gastroenterol J. 2014 Dec.

Abstract

We aimed to evaluate the impact of emergency single-balloon enteroscopy (SBE) on the diagnosis and treatment for active overt obscure gastrointestinal bleeding (OGIB).

Methods: SBE procedures for OGIB were retrospectively reviewed and sub-divided according to the bleeding types: active-overt and inactive-overt bleeding. The patient's history, laboratory results, endoscopic findings and therapeutic interventions were registered. Emergency SBE was defined as an endoscopy that was performed for active-overt OGIB, within 24 hours of clinical presentation.

Results: Between January 2010 and February 2013, 53 SBEs were performed in 43 patients with overt OGIB. Seventeen emergency SBEs were performed in 15 patients with active overt-OGIB procedures (group A), which diagnosed the bleeding source in 14: angiodysplasia (n = 5), ulcers/erosions (n = 3), bleeding tumors (gastrointestinal stromal tumor (GIST), n = 3; neuroendocrine tumor, n = 1), and erosioned polyps (n = 2). Endoscopic treatment was performed in nine patients, with one or multiple hemostatic therapies: argon plasma coagulation (n = 5), epinephrine submucosal injection (n = 5), hemostatic clips (n = 3), and polypectomy (n = 2). Twenty-eight patients with inactive bleeding (group B) were submitted to 36 elective SBEs, which successfully diagnosed 18 cases. The diagnostic yield in group A (93.3%) was significantly higher than in group B (64.3%)-Fisher's exact test, p = 0.038.

Conclusion: This study revealed an important role of emergency SBE in the diagnosis of bleeding etiology in active overt OGIB.

Keywords: Single-balloon enteroscopy; active OGIB; balloon-assisted enteroscopy; emergency single-balloon enteroscopy; obscure gastrointestinal bleeding.

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Figures

Figure 1.
Figure 1.
Bleeding angiodysplasia in the jejunum.
Figure 2.
Figure 2.
Ulcers in the distal ileum.
Figure 3.
Figure 3.
Bleeding gastrointestinal stromal tumor (GIST) in the distal ileum.
Figure 4.
Figure 4.
Erosioned congestive polyp in the jejunum.
See this image and copyright information in PMC

References

    1. Matsumoto T, Esaki M, Moriyama T, et al. Comparison of capsule endoscopy and enteroscopy with the double-balloon method in patients with obscure bleeding and polyposis. Endoscopy 2005; 37: 827–832. - PubMed
    1. Nakamura M, Niwa Y, Ohmiya N. Preliminary comparison of capsule endoscopy and double-balloon enteroscopy in patients with suspected small-bowel bleeding. Endoscopy 2006; 38: 59–66. - PubMed
    1. Hadithi M, Heine GD, Jacobs MA, et al. A prospective study comparing video capsule endoscopy with double-balloon enteroscopy in patients with obscure gastrointestinal bleeding. Gastroenterology 2006; 131: 327–329. - PubMed
    1. Hayat M, Axon AT, O’Mahony S. Diagnostic yield and effect on clinical outcomes of push enteroscopy in suspected small bowel bleeding. Endoscopy 2000; 32: 369–372. - PubMed
    1. Nguyen NQ, Rayner CK, Schoeman MN. Push enteroscopy alters management in a majority of patients with obscure gastrointestinal bleeding. J Gastroenterol Hepatol 2005; 20: 716–721. - PubMed