Copyright
©The Author(s) 2017.
World J Gastroenterol. Jan 28, 2017; 23(4): 614-621
Published online Jan 28, 2017. doi: 10.3748/wjg.v23.i4.614
Published online Jan 28, 2017. doi: 10.3748/wjg.v23.i4.614
Table 1 Patient characteristics n (%)
| DBE negative | DBE positive | Total | P value | |
| (n = 164) | (n = 331) | (n = 495) | ||
| Age at DBE, median (range) | 65.0 (18.1-95.4) | 69.5 (18.3-91.8) | 68.2 (18.1-95.4) | 0.0051 |
| Gender | 0.1042 | |||
| Male | 71 (43.3) | 169 (51.1) | 240 (48.5) | |
| Female | 93 (56.7) | 162 (48.9) | 255 (51.5) | |
| Altered anatomy | 0.7362 | |||
| None | 125 (76.2) | 249 (75.2) | 374 (75.6) | |
| Roux-en-Y | 13 (7.9) | 21 (6.3) | 34 (6.9) | |
| Billroth/Ileo-colonic/IPAA | 7 (4.3) | 21 (6.3) | 28 (5.7) | |
| Other | 19 (11.6) | 40 (12.1) | 59 (11.9) | |
| On warfarin | 19 (11.6) | 36 (10.9) | 55 (11.1) | 0.8132 |
| On clopidogrel | 7 (4.3) | 20 (6.0) | 27 (5.5) | 0.4132 |
| On ASA 325 | 49 (29.9) | 118 (35.6) | 167 (33.7) | 0.2012 |
| VCE performed within 1 yr prior to DBE | 47 (29.4) | 130 (40.9) | 177 (36.9) | |
| MPCTE performed within 1 yr prior to DBE | 31 (19.4) | 53 (16.7) | 84 (17.5) | |
| VCE and MPCTE performed within 1 yr prior to DBE | 67 (41.9) | 113 (35.5) | 180 (37.8) | |
| DBE performed without VCE and MPCTE done | 15 (9.4) | 22 (6.9) | 37 (7.7) | |
| Type of OGIB | 0.7282 | |||
| Overt | 82 (50.0) | 171 (51.7) | 253 (51.1) | |
| Occult | 82 (50.0) | 160 (48.3) | 242 (48.9) | |
| Type of approach of DBE | < 0.0012 | |||
| Anterograde | 103 (62.8) | 268 (81.0) | 371 (74.9) | |
| Retrograde | 61 (37.2) | 63 (19.0) | 124 (25.1) | |
| Total enteroscopy done | 9 (5.5) | 15 (4.5) | 24 (4.8) | 0.6412 |
| Procedure location | 0.3932 | |||
| Inpatient | 34 (20.7) | 80 (24.2) | 114 (23.0) | |
| Outpatient | 130 (79.3) | 251 (75.8) | 381 (77.0) |
Table 2 Double balloon enteroscopy findings, therapy and complications n (%)
| DBE negative | DBE positive | Total | |
| (n = 145) | (n = 296) | (n = 441) | |
| DBE findings | |||
| Angioectasia/arterio venous malformation | 0 (0.0) | 212 (71.6) | 212 (48.1) |
| Dieulafoy lesion | 0 | 8 (2.7) | 8 (1.8) |
| Varix | 0 | 3 (1.0) | 3 (0.7) |
| Evidence of Crohn’s disease | 0 | 5 (1.7) | 5 (1.1) |
| Erythema | 0 | 19 (6.4) | 19 (4.3) |
| Erosion | 0 | 31 (10.1) | 31 (6.8) |
| Ulcer | 0 | 56 (18.9) | 56 (12.7) |
| Polyp identified | 0 | 50 (16.9) | 50 (11.3) |
| Other findings | 40 (27.6) | 64 (21.6) | 104 (23.6) |
| Therapy and complications | |||
| Any therapy done? | 4 (2.8) | 296 (100) | 300 (68.0) |
| Epinephrine injection | 1 (0.7) | 2 (0.7) | 3 (0.7) |
| Biopsy | 3 (2.1) | 89 (30.1) | 92 (20.9 ) |
| Clipping | 0 | 67 (22.6) | 67 (15.2) |
| Argon plasma coagulation | 0 | 213 (72.0) | 213 (48.3) |
| Bipolar cauterization | 0 | 10 (3.4) | 10 (2.3) |
| Early re-bleeding (< 24 h) | 0 | 7 (2.4) | 7 (1.6) |
| Late re-bleeding (24 h-1 yr) | 4 (2.8) | 14 (4.7) | 18 (4.1) |
| Pancreatitis | 0 | 1 (0.3) | 1 (0.2) |
Table 3 Video capsule endoscopy and multiphase computed tomography enterography findings of all patients who had a video capsule endoscopy and multiphase computed tomography enterography performed within 1 year prior to double balloon enteroscopy n (%)
| Capsule endoscopy | Computed tomography enterography | |||||||
| DBE negative | DBE positive | Total | P value | DBE negative | DBE positive | Total | P value | |
| (n = 104) | (n = 233) | (n = 337) | (n = 95) | (n = 157) | (n = 252) | |||
| Capsule endoscopy positive | 74 (71.2) | 171 (73.4) | 245 (72.7) | 0.6922 | ||||
| MPCTE positive | 27 (28.4) | 55 (35.0) | 82 (32.5) | 0.3322 | ||||
| Days from VCE to DBE, median (range) | 42 (0-356) | 35 (0-351) | 37 (0-356) | 0.9241 | ||||
| Days from MPCTE to DBE, median (range) | 19 (0-338) | 29 (0-351) | 23.5 (0-351) | 0.1621 | ||||
| VCE and DBE within 30 d of each other | 41 (39.4) | 105 (45.1) | 146 (43.3) | 0.3442 | ||||
| MPCTE and DBE within 30 d of each other | 59 (62.1) | 84 (53.5) | 143 (56.7) | 0.1922 | ||||
| Arterio-venous malformation | 27 (26.0) | 94 (40.3) | 121 (35.9) | 0.0142 | ||||
| Vascular lesion | 13 (48.1) | 32 (58.2) | 45 (54.9) | 0.1082 | ||||
| Blood | 23 (22.1) | 51 (21.9) | 74 (22.0) | 0.9992 | ||||
| Red spot | 13 (12.5) | 18 (7.7) | 31 (9.2) | 0.2202 | ||||
| Polyp | 4 (3.8) | 12 (5.2) | 16 (4.7) | 0.7842 | ||||
| Ulcer | 17 (16.3) | 20 (8.6) | 37 (11.0) | 0.0402 | 2 (7.4) | 1 (1.8) | 3 (3.7) | |
| Other | 2 (7.4) | 0 (0.0) | 2 (2.4) | |||||
Table 4 Comparison of video capsule endoscopy and multiphase computed tomography enterography in all patients with capsule endoscopy and computed tomography enterography performed within 1 year of double balloon enteroscopy
| Comparison test | Statistic | Count summary | % | 95%CI | |
| Lower limit (%) | Upper limit (%) | ||||
| VCE | Total, n | 337 | |||
| Sensitivity | 171/233 | 73.4 | 67.7 | 79.1 | |
| Specificity | 30/104 | 28.8 | 20.1 | 37.6 | |
| DX yield | 245/337 | 72.7 | 67.9 | 77.5 | |
| Accuracy | 201/337 | 59.6 | 54.4 | 64.9 | |
| MPCTE | Total, n | 252 | |||
| Sensitivity | 55/157 | 35.0 | 27.6 | 42.5 | |
| Specificity | 68/95 | 71.6 | 62.5 | 80.6 | |
| DX yield | 82/252 | 32.5 | 26.8 | 38.3 | |
| Accuracy | 123/252 | 48.8 | 42.6 | 55.0 | |
- Citation: Law R, Varayil JE, WongKeeSong LM, Fidler J, Fletcher JG, Barlow J, Alexander J, Rajan E, Hansel S, Becker B, Larson JJ, Enders FT, Bruining DH, Coelho-Prabhu N. Assessment of multi-modality evaluations of obscure gastrointestinal bleeding. World J Gastroenterol 2017; 23(4): 614-621
- URL: https://www.wjgnet.com/1007-9327/full/v23/i4/614.htm
- DOI: https://dx.doi.org/10.3748/wjg.v23.i4.614