| Theme |
An algorithm for finding and treatment of small intestinal disease -- DBE and CE |
| Title |
Diagnosis and treatment for small intestinal bleeding |
| Author |
Daigo Arakawa |
Department of Gastroenterology, Nagoya University Graduate School of Medicine |
| Author |
Naoki Ohmiya |
Department of Gastroenterology, Nagoya University Graduate School of Medicine |
| Author |
Masanao Nakamura |
Department of Gastroenterology, Nagoya University Graduate School of Medicine |
| Author |
Wataru Honda |
Department of Gastroenterology, Nagoya University Graduate School of Medicine |
| Author |
Hidemi Goto |
Department of Gastroenterology, Nagoya University Graduate School of Medicine |
| [ Summary ] |
Double balloon endoscopy (DBE) and capsule endoscopy (CE) are breakthrough for diagnosis of small bowel diseases, especially of obscure gastrointestinal bleeding (OGIB). The usefulness of DBE for diagnosis and treatment of OGIB, and clarified the characteristics of small intestinal hemorrhagic diseases was evaluated. Diagnostic yields for DBE were 82 /146 (56.2 %) in 146 patients with OGIB. This was especially true in 13 patients with on going bleeding observed with DBE, where the out of diagnostic yields were highest at 11 out of 13 cases (84.6 %). Indentified bleeding sources were treated in 51 out of 82 cases (62.2 %). Endoscopic therapies (electrocoagulation, clipping, and EMR) were performed in 27 cases. Surgical treatment was performed in 24 cases (including laparoscopic surgery with endoscopic tatooing in 14 cases). In relation to the prognosis after DBE, the rate of rebleeding in vascular diseases was significantly higher than that in non-vascular diseases (p = 0.006, logrank test). In 73 patients who had undergone both DBE and CE, positive findings rates for DBE and CE were 43 / 73 (58.9 %) and 38 / 73 (52.1 %), respectively (not significant). However, it is necessary to perform both DBE or CE to compensate for the shortcomings of each other. In this study the diagnostic algorithms for OGIB were examined. |