Small Bowel Endoscopy Diagnostic Yield and Reasons of Obscure GI Bleeding in Chinese Patients.

Ya-Fei He,Ning-Bo Hao,Shi-Ming Yang,Li Yang,Zhong-Li Liao,Hong Guo,Jin Yu,Wu-Chen Yang,Chao-Qiang Fan,Jian-Ying Bai

doi:10.1155/2014/437693

Ya-Fei He, Ning-Bo Hao + Show 8 more

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https://doi.org/10.1155/2014/437693

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Abstract

Aim. To investigate the diagnostic yield and etiologies of patients with obscure gastrointestinal bleeding (OGIB) using capsule endoscopy (CE) or double-balloon enteroscopy (DBE). Method. We studied the data of 532 consecutive patients with OGIB that were referred to Xinqiao Hospital in Chongqing from December 2005 to January 2012. A lesion that was believed to be the source of the bleeding (ulceration, mass lesion, vascular lesion, visible blood, inflammation, or others) was considered to be a positive finding. We analyzed the diagnostic yield of CE and SBE and the etiologies of OGIB. Result. CE and SBE have similar diagnostic yields, at 71.9% (196/231) and 71.8% (251/304), respectively. The most common etiology was erosions/ulceration (27.1%) followed by mass lesion (19.4%) and angiodysplastic/vascular lesions (13.9%). By stratified analysis, we found that erosions/ulceration (27.1%) was the most common etiology for the 21–40-year age group. Mass lesion was the most common etiology in the 41–60-year age group. However, in the >60 years age group, angiodysplastic/vascular lesions were significantly increased compared with the other groups, even though erosions/ulceration was most common. Conclusion. In this study, we found that CE and SBE have similar diagnostic yields and erosions/ulceration was the most common reason for OGIB, followed by mass lesion and angiodysplasias.

Highlights

Obscure gastrointestinal bleeding (OGIB) is defined as recurrent or persistent bleeding or iron deficiency anemia after a negative initial evaluation by gastric and colonic endoscopy [1]
We have reported on the diagnostic yield of these methods and the etiology in 532 patients with OGIB in the southwest of China
The main information obtained from this study was that the diagnostic yields for significant lesions by capsule endoscopy (CE) and double-balloon enteroscopy (DBE) were similar (71.9% versus 71.8%)

Summary

Introduction

Obscure gastrointestinal bleeding (OGIB) is defined as recurrent or persistent bleeding or iron deficiency anemia after a negative initial evaluation by gastric and colonic endoscopy [1]. It has been reported that OGIB is responsible for 5% of all gastrointestinal bleeding and that most of the lesions are in the small bowel [2]. With the development of capsule endoscopy (CE) and double-balloon enteroscopy (DBE), the study of the small bowel has been revolutionized. It has been demonstrated that CE is superior for detecting abnormal lesions noninvasively, with a higher rate of complete small bowel examination, and SBE is superior for endoscopic treatment [7, 8]. The main etiology for OGIB was considered to be angiodysplastic lesions [9, 10]. 532 patients with OGIB in our hospital from 2006 to 2012 were examined by CE or DBE and the etiologies were retrospectively analyzed

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