Brief Article
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. Apr 21, 2010; 16(15): 1885-1889
Published online Apr 21, 2010. doi: 10.3748/wjg.v16.i15.1885
Non-small-bowel lesions encountered during double-balloon enteroscopy performed for obscure gastrointestinal bleeding
Hoi-Poh Tee, Arthur J Kaffes
Hoi-Poh Tee, Arthur J Kaffes, A W Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney 2050, Australia
Author contributions: Tee HP and Kaffes AJ collated the data, performed the statistical analysis and wrote the paper; Kaffes AJ performed the bulk of the procedures; Tee HP assisted the more recent cases.
Correspondence to: Dr. Arthur J Kaffes, A W Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown Rd, Sydney 2050, Australia. arthur@kaffes.com
Telephone: +61-2-83050000 Fax: +61-2-83050001
Received: November 16, 2009
Revised: January 15, 2010
Accepted: January 22, 2010
Published online: April 21, 2010
Abstract

AIM: To report the incidence of non-small-bowel bleeding pathologies encountered during double-balloon enteroscopy (DBE) procedures and to analyse their significance.

METHODS: A retrospective study of a prospective DBE database conducted in a tertiary-referral center was conducted. A total of 179 patients with obscure gastrointestinal bleeding (OGIB) referred for DBE from June 2004 to November 2008 were analysed looking for the incidence of non-small-bowel lesions (NSBLs; all and newly diagnosed) encountered during DBE.

RESULTS: There were 228 (150 antegrade and 78 retrograde) DBE procedures performed in 179 patients. The mean number of DBE procedures was 1.27 per patient. The mean age (SD) of the patients was 62 ± 16 years old. There were 94 females (52.5%). The positive yield for a bleeding lesion was 65.9%. Of the 179 patients, 44 (24.6%) had NSBLs (19 of them had dual pathology with small-bowel lesions and NSBLs); 27 (15.1%) had lesions not detected by previous endoscopies. The most common type of missed lesions were vascular lesions.

CONCLUSION: A significant proportion of patients (24.6%) had lesions within reach of conventional endoscopy. Careful repeat examination with gastroscopy and colonoscopy might be required.

Keywords: Bleeding; Obscure gastrointestinal bleeding; Endoscopy; Double-balloon enteroscopy