Long-term follow-up of patients undergoing capsule and double-balloon enteroscopy for identification and treatment of small-bowel vascular lesions: a prospective, multicenter study

Aim. Causes, clinical features, and diagnostic approaches for small bowel (SB) bleeding were analyzed to derive recommendations in dealing with this clinical condition. Methods. We included 54 patients undergoing surgical treatment for SB bleeding, from January 2009 to December 2019. Detailed clinical data, diagnosis procedures, and causes of bleeding were collected. Results. Among 54 cases with SB bleeding, the most common causes were tumors (64.8%), followed by angiopathy (14.8%), ulcers (9.3%), diverticula (5.6%), tuberculosis (3.7%), and enteritis (1.9%). Most tumors (32/35 cases, 91.4%) and vascular lesions (8/8 cases, 100%) were located in the jejunum. The incidence of tumors was higher in the older (30/41 cases, 73.1%) than that in patients younger than 40 years of age (5/13 cases, 38.5%, P < 0.01 ). Common initial findings were melena (68.5%) and hematochezia (31.5%). The overall diagnostic yield of computed tomographic enterography (CTE) was 57.4% (31/54 cases), with the figures for tumors, vascular lesions, and inflammatory lesions being 71.4% (25/35 cases), 62.5% (5/8 cases), and 12.5% (1/8 cases), respectively. Double-balloon enteroscopy (DBE) definitively identified SB bleeding sources in 16/22 (72.7%) patients. Conclusion. Tumors, angiopathy, ulcers, and diverticula were the most common causes of SB bleeding in Northern Vietnamese population. CTE has a high detection rate for tumors in patients with SB bleeding. CTE as a triage tool may identify patients before double-balloon enteroscopy because of the high prevalence of SB tumors.

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Patients with Small Bowel Angiodysplasia Treated with Argon Beamer During Double Balloon Enteroscopy. Prospective Study with One Year Follow Up

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2008.03.734 ◽

2008 ◽

Vol 67 (5) ◽

pp. AB267

Author(s):

Jorge C. EspinóS ◽

Alfredo Mata ◽

Begoña Gonzalez ◽

Montserrat Forné ◽

Mariel Da Costa ◽

...

Keyword(s):

Small Bowel ◽

Prospective Study ◽

Double Balloon Enteroscopy ◽

Balloon Enteroscopy ◽

Double Balloon ◽

One Year

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Two Modes of Acupuncture as a Treatment for Hot Flushes in Men with Prostate Cancer—A Prospective Multicenter Study with Long-Term Follow-Up

European Urology ◽

10.1016/j.eururo.2008.02.002 ◽

2009 ◽

Vol 55 (1) ◽

pp. 156-163 ◽

Cited By ~ 44

Author(s):

Jessica Frisk ◽

Anna-Clara Spetz ◽

Hans Hjertberg ◽

Bill Petersson ◽

Mats Hammar

Keyword(s):

Prostate Cancer ◽

Multicenter Study ◽

Hot Flushes ◽

Prospective Multicenter Study ◽

Long Term Follow Up

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Outcomes of Double Balloon Enteroscopy for Managing Overt Small Bowel Bleeding

Journal of Digestive Endoscopy ◽

10.1055/s-0040-1713698 ◽

2020 ◽

Vol 11 (02) ◽

pp. 118-125

Author(s):

Ankit Dalal ◽

Gaurav Patil ◽

Amit Maydeo

Keyword(s):

Small Bowel ◽

Diagnostic Yield ◽

Patient Acceptance ◽

Double Balloon Enteroscopy ◽

Time Saving ◽

Balloon Enteroscopy ◽

Double Balloon ◽

Antegrade Approach ◽

Small Bowel Bleeding

Abstract Background The commonest therapeutic indications for double balloon enteroscopy (DBE) includes removal of retained video capsules, dilatation of strictures, polypectomy, and managing obscure small bowel bleeding. We review our experience in managing active small bowel bleeding with DBE. Methods A retrospective review was done for all the cases undergoing DBE from August 2017 to July 2019. Patient follow-up data was collected. Results Among 25 cases with a median age of 46.8 (range 25–65 years), 17 males (68%) underwent DBE for suspected small bowel bleeding. The commonest presenting complaint was melena 19 (76%). The findings were positive (diagnostic yield) in 18 (72%) patients with an antegrade approach. Active bleeding was associated with Dieulafoy's lesion (n = 6), gastrointestinal stromal tumors (GIST) (n = 4), jejunal varices (n = 3), angioectasia (n = 3), and ulcer (n = 2), who then underwent successful intervention. The rest of the patients underwent both antegrade and retrograde approach but failed to immediately identify an alternative diagnosis. Mean (standard deviation [SD]) time taken for antegrade enteroscopy was 96.7 (15.3) mins and 67.8 (13.6) mins for retrograde enteroscopy. The median duration between the last bleeding episode and timing of DBE was 9 (range 6–15 hours). No major complications were seen during or immediately postprocedure. Conclusion DBE is useful in identifying and treating active small bowel bleeding. Being invasive and time-intensive, it is easy to miss lesions and, therefore, needs appropriate expertise. DBE does appear to be relatively cheaper, with better patient acceptance and time saving.

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