Negative capsule endoscopy without subsequent enteroscopy does not predict lower long-term rebleeding rates in patients with obscure GI bleeding - 24/08/11
Reprint requests: Jae Hee Cheon, MD, PhD, Department of Internal Medicine, Yonsei University College of Medicine 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South KoreaRésumé |
Background |
Capsule endoscopy (CE) is now widely accepted as a first-line diagnostic modality for obscure GI bleeding (OGIB). However, the clinical implications of negative results of CE studies remain unclear.
Objective |
To investigate long-term (>1 year) outcomes for patients undergoing CE for OGIB and to identify risk factors associated with rebleeding.
Design and Setting |
Retrospective study in a tertiary care hospital.
Methods |
A total of 57 consecutive patients who had undergone CE for OGIB were enrolled and their pre- and post-CE clinical data were collected. Specific treatments were defined as treatments directly aimed at presumed bleeding causes including hemostasis and disease-specific medical therapy, whereas nonspecific treatments were defined as symptomatic treatments for anemia.
Results |
Of the 57 patients, the indication for CE was obscure-overt bleeding in 46 patients and obscure-occult bleeding in 11 patients. Among 51 patients for whom long-term data were available, significant (P2) lesions were found in 23 (45.1%) patients. The overall rebleeding rate was 35.3% during a median follow-up duration of 31.7 months (range 12.8-58.0 months). There was no statistically significant difference in the cumulative rebleeding rate between patients with positive and negative CE results (34.8% vs 35.7%, respectively; P = .989). However, specific treatments after CE (hazard ratio, 0.111; 95% CI, 0.013-0.980; P = .043) significantly decreased rebleeding.
Limitations |
Small number of patients, retrospective study design.
Conclusions |
The rebleeding rate for patients with OGIB and negative CE results was substantial, indicating that these patients should be closely observed. However, specific treatment after CE significantly reduced the incidence of recurrent bleeding.
Le texte complet de cet article est disponible en PDF.Abbreviations : CE, CTE, DBE, NSAID, OGIB
Plan
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
|
| If you would like to chat with one of the authors of this article, you may contact Dr. Cheon at geniushee@yuhs.ac. |
Vol 71 - N° 6
P. 990-997 - mai 2010 Retour au numéro
Article précédent
- Double-balloon enteroscopy in the elderly: safety, findings, and diagnostic and therapeutic success
- Sanjay R. Hegde, Kevan Iffrig, Tianyu Li, Sharon Downey, Stephen J. Heller, Jeffrey L. Tokar, Oleh Haluszka
- Postpolypectomy bleeding in patients undergoing colonoscopy on uninterrupted clopidogrel therapy
- Mandeep Singh, Nilesh Mehta, Uma K. Murthy, Vivek Kaul, Asma Arif, Nancy Newman
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?