Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May;35(5):2119-2125.
doi: 10.1007/s00464-020-07615-3. Epub 2020 May 7.

Low rate of recurrent bleeding after double-balloon endoscopy-guided therapy in patients with overt obscure gastrointestinal bleeding

Satimai Aniwan  1 , Vichai Viriyautsahakul  1 , Thanawat Luangsukrerk  2 , Phonthep Angsuwatcharakon  1 , Panida Piyachaturawat  1 , Pradermchai Kongkam  1 , Natanong Kongtab  1 , Sombat Treeprasertsuk  1 , Pinit Kullavanijaya  1 , Rungsun Rerknimitr  3
Affiliations

Low rate of recurrent bleeding after double-balloon endoscopy-guided therapy in patients with overt obscure gastrointestinal bleeding

Satimai Aniwan et al. Surg Endosc. 2021 May.

Abstract

Background: Double-balloon endoscopy (DBE) provides both diagnosis and treatment in overt obscure gastrointestinal bleeding (OGIB). The aim of this study was to evaluate the rebleeding rate after DBE.

Methods: This retrospective review was conducted between January 2006 and July 2018, 166 patients with overt OGIB who underwent DBE were enrolled. Therapeutic intervention was defined as endoscopic treatment, embolization, or surgery. Primary outcome was rebleeding rate after DBE. The patients were divided into 3 groups based on their DBE; (1) positive DBE requiring therapeutic intervention (G1), (2) positive DBE without therapeutic intervention required (G2) and (3) negative DBE (G3). Cumulative incidence of rebleeding was estimated using the Kaplan-Meier method. Cox regression was used to assess the association of DBE with rebleeding risk. This study was approved by our Institutional Review Board.

Results: Sixty-eight patients (41%) were categorized in G1, 34 patients (20%) in G2 and 64 patients (39%) in G3. Overall rebleeding occurred in 24 patients (15%). The cumulative incidence of rebleeding for G1 was the lowest. The 1-year and 2-year cumulative probability of developing rebleeding after DBE in G1 were 3.5% and 3.5%, 8.2% and 14.0% in G2, and 18.2% and 20.6% in G3, respectively (p = 0.02). After adjusting for bleeding severity and comorbidities, patients with positive DBE requiring therapeutic intervention had a significantly lower rate of rebleeding when compared with patients who did not receive intervention (hazard ratio 0.17; 95% CI 0.03-0.90).

Conclusion: DBE-guided therapeutic intervention was associated with a lower risk of rebleeding when compared with those with negative and positive DBE without therapeutic intervention. One-fifth of patients with overt OGIB had false negative after DBE.

Keywords: Endoscopy; Obscure gastrointestinal bleeding; Outcome; Small bowel bleeding.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. ASGE Standards of Practice Committee, Fisher L, Lee Krinsky M, Anderson MA, Appalaneni V, Banerjee S, Ben-Menachem T, Cash BD, Decker GA, Fanelli RD, Friis C, Fukami N, Harrison ME, Ikenberry SO, Jain R, Jue T, Khan K, Maple JT, Strohmeyer L, Sharaf R, Dominitz JA (2010) The role of endoscopy in the management of obscure GI bleeding. Gastrointest Endosc 72:471–479 - DOI
    1. Gerson LB, Fidler JL, Cave DR, Leighton JA (2015) ACG Clinical guideline: diagnosis and management of small bowel bleeding. Am J Gastroenterol 110:1265–1287 (quiz 1288) - DOI
    1. Shinozaki S, Yamamoto H, Yano T, Sunada K, Miyata T, Hayashi Y, Arashiro M, Sugano K (2010) Long-term outcome of patients with obscure gastrointestinal bleeding investigated by double-balloon endoscopy. Clin Gastroenterol Hepatol 8:151–158 - DOI
    1. Pennazio M, Santucci R, Rondonotti E, Abbiati C, Beccari G, Rossini FP, De Franchis R (2004) Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology 126:643–653 - DOI
    1. Gerson LB, Batenic MA, Newsom SL, Ross A, Semrad CE (2009) Long-term outcomes after double-balloon enteroscopy for obscure gastrointestinal bleeding. Clin Gastroenterol Hepatol 7:664–669 - DOI

LinkOut - more resources