Seong Ran Jeon1, Jeong-Sik Byeon2, Hyun Joo Jang3, Soo Jung Park4, Jong Pil Im5, Eun Ran Kim6, Ja Seol Koo7, Bong Min Ko8, Dong Kyung Chang6, Jin-Oh Kim1, Su Yeon Park9. 1. Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea. 2. University of Ulsan College of Medicine, Seoul, Korea. 3. Hallym University College of Medicine, Hwasung, Korea. 4. Yonsei University College of Medicine, Seoul, Korea. 5. Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea. 6. Sungkyunkwan University School of Medicine, Seoul, Korea. 7. Korea University College of Medicine, Ansan, Korea. 8. Soonchunhyang University College of Medicine, Bucheon, Korea. 9. Biostatistical Consulting Unit, Soonchunhyang University Medical Center, Seoul, Korea.
Abstract
BACKGROUND AND AIMS: Angioectasias are the most common sources of bleeding in the small bowel. They can be treated using balloon-assisted enteroscopy (BAE). This study aimed to identify the rebleeding rate and associated factors after BAE in patients with small bowel angioectasia bleeding. METHODS: We retrospectively analyzed the records of patients with bleeding due to small bowel vascular lesion in a multicenter enteroscopy database including 1108 BAEs. Finally, in rebleeding analysis, we analyzed 66 patients with angioectasia on the basis of the Yano-Yamamoto classification. Patients who had undergone endotherapy (ET) were divided into ET (n = 45) and non-ET (n = 21) groups. Rebleeding was defined as evidence of bleeding at least 30 days after BAE. RESULTS: Fifty-three patients (80.4%) underwent only one-side enteroscopy. The most common ET was argon plasma coagulation (87.2%). During a mean follow-up duration of 24.5 months, ET and non-ET groups had rebleeding rates of 15.6% and 38.1% (P = 0.059), respectively. Median rebleeding time of ET and non-ET groups was 32.5 and 62 months, respectively. Liver cirrhosis (LC), low platelet count (< 105 /μL), and transfusions were the rebleeding-associated factors in the univariate analysis. In the multivariate analysis, the presence of LC (HR 4.064, 95% CI 1.098-15.045; P = 0.036) was the only independent rebleeding-associated risk factor. CONCLUSIONS: ET using BAE did not significantly affect the rebleeding rate in patients with small bowel angioectasia bleeding. An independent rebleeding risk factor was the presence of LC. Regardless of ET, careful long-term follow-up may be needed, especially in LC patients with small bowel angioectasia bleeding.
BACKGROUND AND AIMS: Angioectasias are the most common sources of bleeding in the small bowel. They can be treated using balloon-assisted enteroscopy (BAE). This study aimed to identify the rebleeding rate and associated factors after BAE in patients with small bowel angioectasia bleeding. METHODS: We retrospectively analyzed the records of patients with bleeding due to small bowel vascular lesion in a multicenter enteroscopy database including 1108 BAEs. Finally, in rebleeding analysis, we analyzed 66 patients with angioectasia on the basis of the Yano-Yamamoto classification. Patients who had undergone endotherapy (ET) were divided into ET (n = 45) and non-ET (n = 21) groups. Rebleeding was defined as evidence of bleeding at least 30 days after BAE. RESULTS: Fifty-three patients (80.4%) underwent only one-side enteroscopy. The most common ET was argon plasma coagulation (87.2%). During a mean follow-up duration of 24.5 months, ET and non-ET groups had rebleeding rates of 15.6% and 38.1% (P = 0.059), respectively. Median rebleeding time of ET and non-ET groups was 32.5 and 62 months, respectively. Liver cirrhosis (LC), low platelet count (< 105 /μL), and transfusions were the rebleeding-associated factors in the univariate analysis. In the multivariate analysis, the presence of LC (HR 4.064, 95% CI 1.098-15.045; P = 0.036) was the only independent rebleeding-associated risk factor. CONCLUSIONS: ET using BAE did not significantly affect the rebleeding rate in patients with small bowel angioectasia bleeding. An independent rebleeding risk factor was the presence of LC. Regardless of ET, careful long-term follow-up may be needed, especially in LC patients with small bowel angioectasia bleeding.
Authors: K V Grooteman; G Holleran; M Matheeuwsen; E J M van Geenen; D McNamara; J P H Drenth Journal: Dig Dis Sci Date: 2019-06-12 Impact factor: 3.199
Authors: Mansour A Parsi; Allison R Schulman; Harry R Aslanian; Manoop S Bhutani; Kuman Krishnan; David R Lichtenstein; Joshua Melson; Udayakumar Navaneethan; Rahul Pannala; Amrita Sethi; Guru Trikudanathan; Arvind J Trindade; Rabindra R Watson; John T Maple Journal: VideoGIE Date: 2019-06-27