Korean J Gastrointest Endosc.  2008 Nov;37(5):321-327.

A Clinical Analysis of Patients with Active Small Bowel Bleeding as Detected on Double Balloon Enteroscopy

• Lee TH
• Kim JO
• Eun SH
• Ko BM
• Cho JY
• Lee JS
• Jin SY
• Lee MS
• Shim CS
• Kim BS

Abstract

BACKGROUND/AIMS: There are few studies that have evaluated active small bowel bleeding. The aim of this study was to evaluate patients with active small bowel bleeding that had been considered as obscure gastrointestinal bleeding an was confirmed by the use of double balloon enteroscopy (DBE).
METHODS
We retrospectively reviewed the medical records of 12 patients with active small bowel bleeding as detected on DBE from January 2005 to September 2007.
RESULTS
The mean patient age was 63 years (age range, 45~80 years) and the patients consisted of seven men and five women. The mean hemoglobin level at admission was 7.6 g/dL (range, 5.8~9.0 g/dL). The mean transfusion volume was 4.4 pints (range, 0~7 pints). Angiodysplasia was the most common cause of bleeding (n=6, 50%), followed by small bowel tumors (n=4, 33%). Other causes included diverticula and a nonspecific ulcer. The most common location of bleeding was the jejunum. Diagnostic yields of capsule endoscopy, a 99mTc RBC scan, an abdomen CT scan, angiography and a small bowel series were 40%, 33%, 25%, 0% and 0%, respectively. Endoscopic treatment was performed successfully in eight patients (67%).
CONCLUSIONS
The most common etiology for active small bowel bleeding is angiodysplasia followed by a small bowel tumor. Other diagnostic methods for the small bowel showed low diagnostic yields. Further investigation of active small bowel bleeding is needed to confirm our results.

Keyword

Double-balloon enteroscopy; Active bleeding; Angiodysplasia; Gastrointestinal stromal tumor; Diverticula

MeSH Terms

Abdomen
Angiodysplasia
Angiography
Capsule Endoscopy
Diverticulum
Double-Balloon Enteroscopy
Female
Gastrointestinal Stromal Tumors
Hemoglobins
Hemorrhage
Humans
Jejunum
Male
Medical Records
Retrospective Studies
Ulcer
Hemoglobins