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  • Title: Incidence of bleeding lesions within reach of conventional upper and lower endoscopes in patients undergoing double-balloon enteroscopy for obscure gastrointestinal bleeding.
    Author: Fry LC, Bellutti M, Neumann H, Malfertheiner P, Mönkemüller K.
    Journal: Aliment Pharmacol Ther; 2009 Feb 01; 29(3):342-9. PubMed ID: 19035975.
    Abstract:
    BACKGROUND: Double-balloon enteroscopy (DBE) is a useful method for evaluation of obscure gastrointestinal bleeding (OGIB). AIM: To determine the incidence of lesions within reach of conventional upper and lower endoscopes as the cause of OGIB in patients referred for DBE. METHODS: All patients undergoing DBE for OGIB during a 3.5-year period at a university hospital were studied. OGIB was defined according to American Gastroenterological Association (AGA) guidelines. RESULTS: One hundred and forty-three DBEs were performed in 107 patients for obscure overt (n=85) and obscure occult (n=22) GIB. Lesions outside the SB as possible sources of GIB were found in 51 patients (47.6%) and a definite source of bleeding outside the small bowel (SB) was detected in 26 patients (24.3%). Lesions considered to explain a definite source of GIB were: gastric ulcer (n=3), duodenal ulcer (n=3), Cameron's lesions (n=2), gastric antral vascular ectasias (n=4), radiation proctitis (n=1), radiation ileitis (n=2), duodenal angiodysplasias (n=1), haemorrhoids with stigmata of recent bleed (n=1), colon angiodysplasias (n=3), colon diverticulosis (n=3), colonic Crohn's disease (n=1), anastomotic ulcers (n=1). CONCLUSIONS: The frequency of non-SB lesions definitely explaining the source of GIB in patients referred for DBE was 24.3%. Therefore, repeat esophago-gastroduodenoscopy (EGD) and ileocolonoscopy should be taken into consideration before DBE.
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