Abstract:
BACKGROUND:Small bowel mass lesions (SBML) are a relatively common cause of obscure gastrointestinal bleeding (OGIB). Their detection has been limited by the inability to endoscopically examine the entire small intestine. This has changed with the introduction of capsule endoscopy (CE) and double balloon enteroscopy (DBE) into clinical practice. STUDY AIM:To evaluate the detection of SBML by DBE and CE in patients with OGIB who were found to have SBML by DBE and underwent both procedures. METHODS:A retrospective review of a prospectively collected database of all patients undergoing DBE for OGIB at seven North American tertiary centers was performed. Those patients who were found to have SBML as a cause of their OGIB were further analyzed. RESULTS:During an 18 month period, 183 patients underwent DBE for OGIB. A small bowel mass lesion was identified in 18 patients. Of these, 15 patients had prior CE. Capsule endoscopy identified the mass lesion in five patients; fresh luminal blood with no underlying lesion in seven patients, and non-specific erythema in three patients. Capsule endoscopy failed to identify all four cases of primary small bowel adenocarcinoma. CONCLUSIONS:Double balloon enteroscopy detects small bowel mass lesions responsible for OGIB that are missed by CE. Additional endoscopic evaluation of the small bowel by DBE or intraoperative enteroscopy should be performed in patients with ongoing OGIB and negative or non-specific findings on CE.
journal_name
Dig Dis Scijournal_title
Digestive diseases and sciencesauthors
Ross A,Mehdizadeh S,Tokar J,Leighton JA,Kamal A,Chen A,Schembre D,Chen G,Binmoeller K,Kozarek R,Waxman I,Dye C,Gerson L,Harrison ME,Haluszka O,Lo S,Semrad Cdoi
10.1007/s10620-007-0110-0subject
Has Abstractpub_date
2008-08-01 00:00:00pages
2140-3issue
8eissn
0163-2116issn
1573-2568journal_volume
53pub_type
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