Causes and Clinical Characteristics of Small Bowel Bleeding in Northern Vietnam

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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Complimentary Imaging Modalities for Investigating Obscure Gastrointestinal Bleeding: Capsule Endoscopy, Double-Balloon Enteroscopy, and Computed Tomographic Enterography

Gastroenterology Research and Practice ◽

10.1155/2016/8367519 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 12

Author(s):

Ye Chu ◽

Sheng Wu ◽

Yuting Qian ◽

Qi Wang ◽

Juanjuan Li ◽

...

Keyword(s):

Small Bowel ◽

Gastrointestinal Bleeding ◽

Capsule Endoscopy ◽

Diagnostic Yield ◽

Obscure Gastrointestinal Bleeding ◽

Double Balloon Enteroscopy ◽

Balloon Enteroscopy ◽

Computed Tomographic ◽

Double Balloon ◽

Complementary Value

Objectives. The complimentary value of computed tomographic enterography (CTE) and double-balloon enteroscopy (DBE) combined with capsule endoscopy (CE) was evaluated in the diagnosis of obscure gastrointestinal bleeding (OGIB).Methods. Patients who received CE examinations at Ruijin Hospital between July 2007 and July 2014 with the indication of OGIB were identified, and those who also underwent DBE and/or CTE were included. Their clinical information was retrieved, and results from each test were compared with findings from the other two examinations.Results. The overall diagnostic yield of CE was comparable with DBE (73.9% versus 60.9%) but was significantly higher than the yield of CTE (87% versus 25%,p<0.001). The diagnostic yield of angiodysplasia at CE was significantly higher than CTE (73% versus 8%,p<0.001) and DBE (39.1% versus 17.4%,p=0.013), while no significant difference was found between the three approaches for small bowel tumors. DBE and CTE identified small bowel diseases undetected or undetermined by CE. Conversely, CE improved diagnosis in the cases with negative CTE and DBE, and findings at initial CE directed further diagnosis made by DBE.Conclusions. Combination of the three diagnostic platforms provides complementary value in the diagnosis of OGIB.

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Long-Term Outcome of Patients Treated With Double Balloon Enteroscopy for Small Bowel Vascular Lesions

The American Journal of Gastroenterology ◽

10.1038/ajg.2011.325 ◽

2012 ◽

Vol 107 (2) ◽

pp. 240-246 ◽

Cited By ~ 65

Author(s):

E Samaha ◽

G Rahmi ◽

B Landi ◽

C Lorenceau-Savale ◽

G Malamut ◽

...

Keyword(s):

Small Bowel ◽

Vascular Lesions ◽

Double Balloon Enteroscopy ◽

Term Outcome ◽

Long Term Outcome ◽

Balloon Enteroscopy ◽

Double Balloon

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Double-Balloon Enteroscopy and Capsule Endoscopy Have Comparable Diagnostic Yield in Small-Bowel Disease: A Meta-Analysis

Clinical Gastroenterology and Hepatology ◽

10.1016/j.cgh.2008.01.005 ◽

2008 ◽

Vol 6 (6) ◽

pp. 671-676 ◽

Cited By ~ 242

Author(s):

Shabana F. Pasha ◽

Jonathan A. Leighton ◽

Ananya Das ◽

M. Edwyn Harrison ◽

G. Anton Decker ◽

...

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Bowel Disease ◽

Diagnostic Yield ◽

Meta Analysis ◽

Small Bowel Disease ◽

Double Balloon Enteroscopy ◽

Balloon Enteroscopy ◽

Double Balloon

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The Diagnostic Value of Double-Balloon Enteroscopy in Children with Small Bowel Disease: Report of 31 Cases

Canadian Journal of Gastroenterology ◽

10.1155/2009/281040 ◽

2009 ◽

Vol 23 (9) ◽

pp. 635-638 ◽

Cited By ~ 23

Author(s):

Wei Liu ◽

Chundi Xu ◽

Jie Zhong

Keyword(s):

Small Bowel ◽

Bowel Disease ◽

Diagnostic Yield ◽

Diagnostic Value ◽

Small Bowel Disease ◽

Double Balloon Enteroscopy ◽

Balloon Enteroscopy ◽

Entire Small Bowel ◽

Double Balloon ◽

Diagnostic Modalities

BACKGROUND AND OBJECTIVE: Before the introduction of double-balloon enteroscopy (DBE), it was impossible to visualize the entire small bowel. Its diagnostic yield has been assessed in adults, but not yet in children. The present retrospective study evaluated the diagnostic usefulness and safety of DBE in children with suspected small bowel disease.METHODS: Between June 2003 and June 2007, 31 patients (19 boys and 12 girls, age range three to 14 years) with suspected small bowel disease underwent DBE after receiving negative evaluations using other diagnostic modalities.RESULTS: There were no severe complications. In two patients, the entire small bowel was viewed using oral and anal approaches, and for the remaining 29 patients, only one approach was used. The sites of disease in were identified in 25 of 31 cases (80.65%). The bleeding source was found in 21 of 27 patients with obscure gastrointestinal bleeding (diagnostic rate of 77.78%). Different diseases were identified in four children with chronic diarrhea.CONCLUSION: DBE is a safe and effective method to diagnose patients with suspected small bowel disorders.

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Double-Balloon Enteroscopy (DBE) and Capsule Endoscopy (CE) Have a Comparable Diagnostic Yield in Patients with Suspected Small Bowel Disease: A Meta-Analysis

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2007.03.945 ◽

2007 ◽

Vol 65 (5) ◽

pp. AB364 ◽

Cited By ~ 3

Author(s):

Shabana F. Pasha ◽

Jonathan A. Leighton ◽

Ananya Das ◽

M. Edwyn Harrison ◽

G. Anton Decker ◽

...

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Bowel Disease ◽

Diagnostic Yield ◽

Meta Analysis ◽

Small Bowel Disease ◽

Double Balloon Enteroscopy ◽

Balloon Enteroscopy ◽

Double Balloon

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Diagnostic yield, therapeutic impact, and complications of double-balloon enteroscopy in patients with small-bowel pathology

Surgical Endoscopy ◽

10.1007/s00464-007-9592-2 ◽

2007 ◽

Vol 22 (5) ◽

pp. 1223-1226 ◽

Cited By ~ 7

Author(s):

R. Barreto-Zuñiga ◽

F. I. Tellez-Avila ◽

N. C. Chavez-Tapia ◽

M. A. Ramirez-Luna ◽

E. Sanchez-Cortes ◽

...

Keyword(s):

Small Bowel ◽

Diagnostic Yield ◽

Double Balloon Enteroscopy ◽

Balloon Enteroscopy ◽

Therapeutic Impact ◽

Double Balloon

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Indications and Diagnostic Yield of Double Balloon Enteroscopy in a Tertiary Care Setting: An Analysis of 527 Cases with Suspected Small Bowel Diseases

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2008.03.740 ◽

2008 ◽

Vol 67 (5) ◽

pp. AB268

Author(s):

Jumpei Kondo ◽

Shingo Tsuji ◽

Hideki Iijima ◽

Masahiko Tsujii ◽

Tsutomu Nishida ◽

...

Keyword(s):

Small Bowel ◽

Care Setting ◽

Diagnostic Yield ◽

Tertiary Care ◽

Double Balloon Enteroscopy ◽

Balloon Enteroscopy ◽

Double Balloon ◽

Bowel Diseases ◽

Tertiary Care Setting ◽

Small Bowel Diseases

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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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