Less favorable clinical outcome after diagnostic and interventional double balloon enteroscopy in patients with suspected small-bowel bleeding?

Endoscopy. 2008 Sep;40(9):731-4. doi: 10.1055/s-2008-1077521. Epub 2008 Aug 12.

Abstract

Background and study aims: Double balloon enteroscopy (DBE) is a new endoscopic technique that allows diagnosis and therapeutic interventions of small-bowel lesions. One of the main indications for DBE is suspected small-bowel bleeding (SSBB). Data about clinical outcome after DBE are limited. The aim of the present study was to prospectively assess the short-term clinical outcome of this procedure.

Patients and methods: Of all consecutive patients undergoing DBE for various indications, follow-up results in patients with SSBB were analyzed. Standardized questionnaires were used, including assessment of gastrointestinal symptoms, especially signs of gastrointestinal bleeding, blood transfusions, demand for re-intervention, and hospitalization.

Results: Of a total of 180 DBEs performed in 124 patients during a 2-year period, SSBB was the indication in 84 patients (M/F = 46/38; mean age 63 years) who underwent a total of 111 DBEs. Of these patients 52 could be followed (mean follow-up 2 months, range 1-5 months). In this subgroup, positive findings were obtained in 30 (mostly angiodysplasia), with therapeutic interventions being performed in 18 of these patients. At follow-up, the rate of re-bleeding in patients who had undergone interventions (20%) was similar to that in patients who had not (18%).

Conclusion: In this pilot study, DBE did not seem to have a major effect on re-bleeding. Better patient selection or modification of therapeutic regimens appears to be necessary to better utilize DBE in SSBB.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Transfusion / statistics & numerical data
  • Catheterization / adverse effects*
  • Endoscopy, Gastrointestinal / adverse effects*
  • Female
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage / complications*
  • Humans
  • Intestinal Diseases / complications
  • Intestinal Diseases / diagnosis*
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Recurrence
  • Surveys and Questionnaires