Double-balloon enteroscopy (DBE) in patients presenting with obscure gastrointestinal bleeding (OGIB)

被引:6
作者
Sheba, Esmat [1 ]
Farag, Ali [1 ]
Aref, Wael [1 ]
Elkholy, Shaimaa [1 ]
Ashoush, Omar [1 ]
机构
[1] Cairo Univ, Fac Med, Internal Med Dept, Cairo, Egypt
关键词
Double balloon enteroscopy; Obscure gastrointestinal bleeding; WIRELESS CAPSULE ENDOSCOPY; SMALL-BOWEL DISEASE; DIAGNOSTIC YIELD; CLINICAL GUIDELINE; OCCULT; ENTEROCLYSIS; EXPERIENCE; MANAGEMENT; ANEMIA; IMPACT;
D O I
10.1016/j.ajg.2017.11.001
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and study aims: Obscure gastrointestinal bleeding (OGIB) is defined as bleeding of unknown origin that persists or recurs after an initial negative investigation. Identifying the source of OGIB represents a diagnostic challenge that is frequently focused on visualizing the small intestine. Conventional diagnostic methods, such as push enteroscopy, small-bowel follow-through, radionuclide scanning, and angiography, each exhibit inherent limitations. Double balloon enteroscopy (DBE) was designed specifically to evaluate the entire small bowel. DBE allows for better visualization, biopsy of the identified lesions and application of therapeutic techniques. This study sought to assess the role of DBE in the diagnosis and management of patients with OGIB. Patients and methods: This prospective study was conducted to analyse data from 31 patients presenting with OGIB referred for DBE in the Endoscopy Unit at the Internal Medicine Department of the Faculty of Medicine, Cairo University. Results: Five patients had lesions in locations other than the small intestine that accounted for GI bleeding. Thus, the potential source of OGIB was defined as the small intestine in 18 of 26 patients (69.2%), and negative DBE findings were noted in eight patients (30.8%). Major findings included small intestinal tumours in eight patients, vascular bleeding lesions in 8 patients and ulcerations in 2 patients. Endoscopic haemostasis was performed in eight patients with vascular lesions. The three patients with Petuz-Jegher syndrome underwent polypectomy of their major polyps. Patients with gastrointestinal tumours were referred for surgery. Conclusion: DBE is an excellent endoscopic procedure that has a relatively high diagnostic and therapeutic yield. The procedure is feasible and exhibits a high safety profile with a low complication rate when performed by an experienced endoscopist. (C) 2017 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:228 / 233
页数:6
相关论文
共 50 条
[21]   A Prospective Study on Evaluating the Diagnostic Yield of Video Capsule Endoscopy Followed by Directed Double-Balloon Enteroscopy in Patients with Obscure Gastrointestinal Bleeding [J].
Xiaobo Li ;
Jun Dai ;
Hong Lu ;
Yunjie Gao ;
Huimin Chen ;
Zhizheng Ge .
Digestive Diseases and Sciences, 2010, 55 :1704-1710
[22]   Usefulness of small bowel reexamination in obscure gastrointestinal bleeding patients with negative capsule endoscopy findings: Comparison of repeat capsule endoscopy and double-balloon enteroscopy [J].
Otani, Koji ;
Watanabe, Toshio ;
Shimada, Sunao ;
Nadatani, Yuji ;
Hosomi, Shuhei ;
Nagami, Yasuaki ;
Tanaka, Fumio ;
Kamata, Noriko ;
Taira, Koichi ;
Yamagami, Hirokazu ;
Tanigawa, Tetsuya ;
Shiba, Masatsugu ;
Fujiwara, Yasuhiro .
UNITED EUROPEAN GASTROENTEROLOGY JOURNAL, 2018, 6 (06) :879-887
[23]   Clinical impact of multidetector computed tomography before double-balloon enteroscopy for obscure gastrointestinal bleeding [J].
Hsu-Heng Yen ;
Chia-Wei Yang ;
Maw-Soan Soon .
World Journal of Gastroenterology, 2012, (07) :692-697
[24]   Investigating obscure gastrointestinal bleeding: capsule endoscopy or double balloon enteroscopy? [J].
Westerhof, J. ;
Weersma, R. K. ;
Koornstra, J. J. .
NETHERLANDS JOURNAL OF MEDICINE, 2009, 67 (07) :260-265
[25]   Is there still a role for intraoperative enteroscopy in patients with obscure gastrointestinal bleeding? [J].
Monsanto, Pedro ;
Almeida, Nuno ;
Lerias, Clotilde ;
Figueiredo, Pedro ;
Gouveia, Hermano ;
Sofia, Carlos .
REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS, 2012, 104 (04) :190-196
[26]   Non-small-bowel lesions encountered during double-balloon enteroscopy performed for obscure gastrointestinal bleeding [J].
Hoi-Poh Tee ;
Arthur J Kaffes .
World Journal of Gastroenterology, 2010, 16 (15) :1885-1889
[27]   A prospective, single-blind trial comparing wireless capsule endoscopy and double-balloon enteroscopy in patients with obscure gastrointestinal bleeding [J].
Kameda, Natsuhiko ;
Higuchi, Kazuhide ;
Shiba, Masatsugu ;
Machida, Hirohisa ;
Okazaki, Hirotoshi ;
Yamagami, Hirokazu ;
Tanigawa, Tftsuya ;
Watanabe, Kenji ;
Watanabe, Toshio ;
Tominaga, Kazunari ;
Fujiwara, Yasuhiro ;
Oshitani, Nobuhide ;
Arakawa, Tetsuo .
JOURNAL OF GASTROENTEROLOGY, 2008, 43 (06) :434-440
[28]   A prospective, single-blind trial comparing wireless capsule endoscopy and double-balloon enteroscopy in patients with obscure gastrointestinal bleeding [J].
Natsuhiko Kameda ;
Kazuhide Higuchi ;
Masatsugu Shiba ;
Hirohisa Machida ;
Hirotoshi Okazaki ;
Hirokazu Yamagami ;
Tetsuya Tanigawa ;
Kenji Watanabe ;
Toshio Watanabe ;
Kazunari Tominaga ;
Yasuhiro Fujiwara ;
Nobuhide Oshitani ;
Tetsuo Arakawa .
Journal of Gastroenterology, 2008, 43 :434-440
[29]   Outcome of patients who have undergone total enteroscopy for obscure gastrointestinal bleeding [J].
Shishido, Takayoshi ;
Oka, Shiro ;
Tanaka, Shinji ;
Imagawa, Hiroki ;
Takemura, Yoshito ;
Yoshida, Shigeto ;
Chayama, Kazuaki .
WORLD JOURNAL OF GASTROENTEROLOGY, 2012, 18 (07) :666-672
[30]   Primary Balloon-assisted Enteroscopy in Patients With Obscure Gastrointestinal Bleeding Findings and Outcome of Therapy [J].
Godeschalk, Mark F. P. ;
Mensink, Peter B. F. ;
van Buuren, Henk R. ;
Kuipers, Ernst J. .
JOURNAL OF CLINICAL GASTROENTEROLOGY, 2010, 44 (09) :E195-E200