BACKGROUND: Double-balloon endoscopy (DBE) and videocapsule endoscopy (VCE) have been useful in managing obscure GI bleeding (OGIB). OBJECTIVE: This study compared diagnostic yields of OGIB between DBE and VCE, and evaluated the outcome after DBE. DESIGN: A single-center retrospective study. SETTING: A tertiary-referral hospital. PATIENTS: Between June 2003 and February 2007, 162 consecutive patients with OGIB were enrolled and treated. The diagnostic yield between VCE and DBE was compared in 74 patients. MAIN OUTCOME MEASUREMENTS: Comparison of diagnostic yields between DBE and VCE, and the prognosis after DBE. RESULTS: Of 162 patients, 95 (59%) were diagnosed with small-bowel diseases. They were treated by medical, enteroscopic, and surgical therapies (n = 35, 30, and 30, respectively). A comparison of the overall diagnostic yield between DBE (64%) and VCE (54%) was not significantly different. The 4 VCE-positive DBE-negative cases were because of inaccessibility of DBE. The 11 VCE-negative DBE-positive cases were because of a failure to detect lesions in the proximal small bowel and the Roux-en-Y loop, and because of diverticula. At a median follow-up of 555 days after DBE, 11 patients with small-bowel diseases developed rebleeding; all were treated by enteroscopic or medical therapies. Vascular diseases, comorbidities, especially portal hypertensive disease and chronic renal failure that required hemodialysis, and severe anemia (Hb </=7.0 g/dL) were associated with rebleeding. LIMITATIONS: A retrospective comparative study, and participation bias. CONCLUSIONS: A complementary combination between DBE and VCE was useful for the management of OGIB. In particular, patients with vascular disease, comorbidities, and severe anemia should be intensively treated.
BACKGROUND: Double-balloon endoscopy (DBE) and videocapsule endoscopy (VCE) have been useful in managing obscure GI bleeding (OGIB). OBJECTIVE: This study compared diagnostic yields of OGIB between DBE and VCE, and evaluated the outcome after DBE. DESIGN: A single-center retrospective study. SETTING: A tertiary-referral hospital. PATIENTS: Between June 2003 and February 2007, 162 consecutive patients with OGIB were enrolled and treated. The diagnostic yield between VCE and DBE was compared in 74 patients. MAIN OUTCOME MEASUREMENTS: Comparison of diagnostic yields between DBE and VCE, and the prognosis after DBE. RESULTS: Of 162 patients, 95 (59%) were diagnosed with small-bowel diseases. They were treated by medical, enteroscopic, and surgical therapies (n = 35, 30, and 30, respectively). A comparison of the overall diagnostic yield between DBE (64%) and VCE (54%) was not significantly different. The 4 VCE-positive DBE-negative cases were because of inaccessibility of DBE. The 11 VCE-negative DBE-positive cases were because of a failure to detect lesions in the proximal small bowel and the Roux-en-Y loop, and because of diverticula. At a median follow-up of 555 days after DBE, 11 patients with small-bowel diseases developed rebleeding; all were treated by enteroscopic or medical therapies. Vascular diseases, comorbidities, especially portal hypertensive disease and chronic renal failure that required hemodialysis, and severe anemia (Hb </=7.0 g/dL) were associated with rebleeding. LIMITATIONS: A retrospective comparative study, and participation bias. CONCLUSIONS: A complementary combination between DBE and VCE was useful for the management of OGIB. In particular, patients with vascular disease, comorbidities, and severe anemia should be intensively treated.
Authors: Jessie Westerhof; Jan J Koornstra; Reinier A Hoedemaker; Wim J Sluiter; Jan H Kleibeuker; Rinse K Weersma Journal: World J Gastroenterol Date: 2012-04-07 Impact factor: 5.742
Authors: Peter T Kalogerinis; John E Poulos; Andrew Morfesis; Anthony Daniels; Stavroula Georgakila; Thomas Daignualt; Alexandros G Georgakilas Journal: BMC Gastroenterol Date: 2010-09-17 Impact factor: 3.067