Outcome of patients who have undergone total enteroscopy for obscure gastrointestinal bleeding

Table 1 Clinical characteristics of patients (n = 75) who underwent total enteroscopy for obscure gastrointestinal bleeding at our hospital, August 2003 to June 2008 (mean ± SD) n (%)

Sex ratio (M/F)	44/31
Age (yr)	62.8 ± 16.9
Comorbid illness
Cardiovascular disease	16 (21.3)
Chronic renal disease	9 (12.0)
Chronic liver disease	6 (8.0)
Cerebrovascular disease	4 (5.3)
Chronic respiratory disease	4 (5.3)
Use of anticoagulants	14 (18.7)
Use of non-steroidal anti-inflammatory drugs	11 (14.7)
Bleeding type
Overt	56 (74.7)
Occult	19 (25.3)
Time from last bleeding episode to DBE (d)	33.2 ± 18.0
Blood transfusion	18 (24.0)
Hb before DBE (g/dL)	10.9 ± 2.5

Number of patients is shown unless otherwise indicated. Hb: Hemoglobin; DBE: Double-balloon endoscopy.

Table 2 Identification and treatment of bleeding source in the small bowel by total enteroscopy

Source of bleeding	n	Bleeding typeovert/occult	Specific therapy
Tumor
Hamartoma	2	1/1	Endoscopic resection (2)
Lipoma	1	1/0	Endoscopic resection (1)
Gastrointestinal stromal tumor	3	3/0	Surgery (3)
Leiomyosarcoma	1	1/0	Surgery (1)
Vascular lesion
Angioectasia	4	3/1	Endoscopic hemostasis (4)
Arteriovenous malformation	1	1/0	Endoscopic hemostasis (1)
Ulcerative lesion
Drug-induced ulcer	9	5/4	Medication (4), clinical observation (5)
Anastomotic ulcer	5	3/2	Endoscopic hemostasis (5)
Nonspecific erosion	4	4/0	Clinical observation (4)
Enteric tuberculosis	3	2/1	Medication (3)
Crohn’s disease	1	1/0	Medication (1)
Radiation enteritis	1	1/0	Endoscopic hemostasis (1)
Other
Meckel’s diverticulum	1	1/0	Medication (1)

Number of patients is shown unless otherwise indicated.

Table 3 Outcome of patients who underwent total enteroscopy for obscure gastrointestinal bleeding (mean ± SD) n (%)

Number of follow-up cases	61
Observation period after DBE (mo)	27.2 ± 13.3
Re-bleeding rate	4 (6.6)
Time period from DBE to re-bleeding episode (mo)	7.0 ± 4.2
Number of patients who underwent transfusion	3 (4.9)
Outcome
Survival	60
Death	1

Number of patients is shown unless otherwise indicated. DBE: Double-balloon endoscopy.

Table 4 Patients with obscure gastrointestinal bleeding in whom re-bleeding occurred after total enteroscopy

Patient	Bleedingtype	Hb (g/dL)	Initialdiagnosis	Initialtreatment	Time afterDBE (mo)	Hb (g/dL)after treatment	Final diagnosis	Secondtreatment	Transfusion	Re-bleedingafter second treatment
78-yr-old woman	Overt	12.3	Enteric tuberculosis	Medication	10	6.6	Enteric tuberculosis	Medication	No	No
66-yr-old woman	Occult	10.1	Enteric tuberculosis	Medication	7	7.5	Enteric tuberculosis	Medication	Yes	No
62-yr-old woman	Overt	10.6	Angioectasia	EH	10	8.3	Angioectasia	EH	Yes	No
65-yr-old woman	Overt	6.5	No source of bleeding	No treatment	1	6.0	Arteriovenous malformation	EH→angiography	Yes	No

Hb: Hemoglobin; EH: Endoscopic hemostasis; DBE: Double-balloon endoscopy.