Browse > Article

The Role of Endoscopy in Obscure Gastrointestinal Bleeding  

Eun, Chang-Soo (Department of Internal Medicine, Hanyang University College of Medicine)
Publication Information
Clinical Endoscopy / v.41, no.6, 2010 , pp. 329-337 More about this Journal
Abstract
Obscure gastrointestinal bleeding (OGIB) is defined as occult or overt bleeding of unknown origin that persists or recurs after an initial negative endoscopic evaluation by gastroscopy or colonoscopy. Most of these problems occur in the small bowel, and it is not an uncommon condition encountered by gastroenterologists, accounting for approximately 5% of all GIB. Traditional endoscopic techniques, including push enteroscopy, have a limited role in diagnosing patients with OGIB because of the inaccessibility of a large part of the small bowel using an endoscopic procedure. The recent introduction of new enteroscopic modalities including capsule endoscopy (CE) and double balloon enteroscopy have allowed mucosal visualization of the entire small bowel, revolutionizing the diagnosis and treatment of patients with OGIB. The respective roles of CE and deep enteroscopy in patients with OGIB are discussed in this review.
Keywords
Obscure gastrointestinal bleeding; Capsule endoscopy; Deep enteroscopy;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Pennazio M, Santucci R, Rondonotti E, et al. Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology 2004;126:643-653.   DOI   ScienceOn
2 Pasha SF, Leighton JA, Das A, et al. Double-balloon enteroscopy and capsule endoscopy have comparable diagnostic yield in small-bowel disease: a meta-analysis. in Gastroenterol Hepatol 2008;6:671-676.   DOI   ScienceOn
3 Viazis N, Papaxoinis K, Vlachogiannakos J, Efthymiou A, Theodoropoulos I, Karamanolis DG. Is there a role for second-look capsule endoscopy in patients with obscure GI bleeding after a nondiagnostic first test? Gastrointest Endosc 2009;69:850-856.   DOI   ScienceOn
4 Fujimori S, Seo T, Gudis K, et al. Diagnosis and treatment of obscure gastrointestinal bleeding using combined capsule endoscopy and double balloon endoscopy: 1-year follow-up study. Endoscopy 2007;39:1053-1058.   DOI   ScienceOn
5 Douard R, Wind P, Panis Y, et al. Intraoperative enteroscopy for diagnosis and management of unexplained gastrointestinal bleeding. Am J Surg 2000;180:181-184.   DOI   ScienceOn
6 May A, Nachbar L, Schneider M, Ell C. Prospective comparison of push enteroscopy and push-and-pull enteroscopy in patients with suspected small-bowel bleeding. Am J Gastroenterol 2006;101:2016-2024.   DOI   ScienceOn
7 Douard R, Wind P, Berger A, et al. Role of intraoperative enteroscopy in the management of obscure gastointestinal bleeding at the time of video-capsule endoscopy. Am J Surg 2009;198:6-11.   DOI   ScienceOn
8 Apostolopoulos P, Liatsos C, Gralnek IM, et al. Evaluation of capsule endoscopy in active, mild-to-moderate, overt, obscure GI bleeding. Gastrointest Endosc 2007;66:1174-1181.   DOI   ScienceOn
9 Vakil N, Huilgol V, Khan I. Effect of push enteroscopy on transfusion requirements and quality of life in patients with unexplained gastrointestinal bleeding. Am J Gastroenterol 1997;92:425-428.
10 Zaman A, Sheppard B, Katon RM. Total peroral intraoperative enteroscopy for obscure GI bleeding using a dedicated push enteroscope: diagnostic yield and patient outcome. Gastrointest Endosc 1999;50:506-510.   DOI   ScienceOn
11 de Leusse A, Vahedi K, Edery J, et al. Capsule endoscopy or push enteroscopy for first-line exploration of obscure gastrointestinal bleeding? Gastroenterology 2007;132:855-862.   DOI   ScienceOn
12 Gerson LB, Tokar J, Chiorean M, et al. Complications associated with double balloon enteroscopy at nine US centers. Clin Gastroenterol Hepatol 2009;7:1177-1182.   DOI   ScienceOn
13 Lara LF, Bloomfeld RS, Pineau BC. The rate of lesions found within reach of esophagogastroduodenoscopy during push enteroscopy depends on the type of obscure gastrointestinal bleeding. Endoscopy 2005;37:745-750.   DOI   ScienceOn
14 Fry LC, Bellutti M, Neumann H, Malfertheiner P, Monkemuller K. Incidence of bleeding lesions within reach of conventional upper and lower endoscopes in patients undergoing double-balloon enteroscopy for obscure gastrointestinal bleeding. Aliment Pharmacol Ther 2009;29:342-349.   DOI   ScienceOn
15 Kim DH, Byeon JS, Lee SK, et al. Usefulness of double balloon endoscopy in patients with surgically distorted intestinal anatomy. J Clin Gastroenterol 2009;43:737-742.   DOI   ScienceOn
16 Leaper M, Johnston MJ, Barclay M, Dobbs BR, Frizelle FA. Reasons for failure to diagnose colorectal carcinoma at colonoscopy. Endoscopy 2004;36:499-503.   DOI   ScienceOn
17 Chak A, Koehler MK, Sundaram SN, Cooper GS, Canto MI, Sivak MV Jr. Diagnostic and therapeutic impact of push enteroscopy: analysis of factors associated with positive findings. Gastrointest Endosc 1998;47:18-22.   DOI   ScienceOn
18 Leighton JA, Wallace MB. Update on small bowel imaging. Gastroenterology 2007;132:1651-1654.   DOI   ScienceOn
19 Descamps C, Schmit A, Van Gossum A. "Missed" upper gastrointestinal tract lesions may explain "occult" bleeding. Endoscopy 1999;31:452-455.   DOI   ScienceOn
20 Marmo R, Rotondano G, Casetti T, et al. Degree of concordance between double-balloon enteroscopy and capsule endoscopy in obscure gastrointestinal bleeding: a multicenter study. Endoscopy 2009;41:587-592.   DOI   ScienceOn
21 ASGE Standards of Practice Committee. Fisher L, Lee Krinsky M, et al. The role of endoscopy in the management of obscure GI bleeding. Gastrointest Endosc 2010;72:471-479.   DOI   ScienceOn
22 Mensink PB, Haringsma J, Kucharzik T, et al. Complications of double balloon enteroscopy: a multicenter survey. Endoscopy 2007;39:613-615.   DOI   ScienceOn
23 May A, Nachbar L, Pohl J, Ell C. Endoscopic interventions in the small bowel using double balloon enteroscopy: feasibility and limitations. Am J Gastroenterol 2007;102:527-535.   DOI   ScienceOn
24 Kaffes AJ, Siah C, Koo JH. Clinical outcomes after double-balloon enteroscopy in patients with obscure GI bleeding and a positive capsule endoscopy. Gastrointest Endosc 2007;66:304-309.   DOI   ScienceOn
25 Madisch A, Schmolders J, Bruckner S, Aust D, Miehlke S. Less favorable clinical outcome after diagnostic and interventional double balloon enteroscopy in patients with suspected small-bowel bleeding? Endoscopy 2008;40:731-734.   DOI   ScienceOn
26 Kitiyakara T, Selby W. Non-small-bowel lesions detected by capsule endoscopy in patients with obscure GI bleeding. Gastrointest Endosc 2005;62:234-238.   DOI   ScienceOn
27 Gerson LB, Flodin JT, Miyabayashi K. Balloon-assisted enteroscopy: technology and troubleshooting. Gastrointest Endosc 2008;68:1158-1167.   DOI   ScienceOn
28 Sun B, Rajan E, Cheng S, et al. Diagnostic yield and therapeutic impact of double-balloon enteroscopy in a large cohort of patients with obscure gastrointestinal bleeding. Am J Gastroenterol 2006;101:2011-2015.   DOI   ScienceOn
29 Gay G, Delvaux M, Fassler I. Outcome of capsule endoscopy in determining indication and route for push-and-pull enteroscopy. Endoscopy 2006;38:49-58.   DOI   ScienceOn
30 Manabe N, Tanaka S, Fukumoto A, Nakao M, Kamino D, Chayama K. Double-balloon enteroscopy in patients with GI bleeding of obscure origin. Gastrointest Endosc 2006;64:135-140.   DOI   ScienceOn
31 Chen X, Ran ZH, Tong JL. A meta-analysis of the yield of capsule endoscopy compared to double-balloon enteroscopy in patients with small bowel diseases. World J Gastroenterol 2007;13:4372-4378.   DOI
32 Zhong J, Ma T, Zhang C, et al. A retrospective study of the application on double-balloon enteroscopy in 378 patients with suspected small-bowel diseases. Endoscopy 2007;39:208-215.   DOI   ScienceOn
33 Zhi FC, Yue H, Jiang B, et al. Diagnostic value of double balloon enteroscopy for small-intestinal disease: experience from China. Gastrointest Endosc 2007;66(suppl 3):19S-21S.   DOI
34 Arakawa D, Ohmiya N, Nakamura M, et al. Outcome after enteroscopy for patients with obscure GI bleeding: diagnostic comparison between double-balloon endoscopy and videocapsule endoscopy. Gastrointest Endosc 2009;69:866-874.   DOI   ScienceOn
35 Mehdizadeh S, Ross A, Gerson L, et al. What is the learning curve associated with double-balloon enteroscopy? Technical details and early experience in 6 U.S. tertiary care centers. Gastrointest Endosc 2006;64:740-750.   DOI   ScienceOn
36 Lai LH, Wong GL, Chow DK, Lau JY, Sung JJ, Leung WK. Long-term follow-up of patients with obscure gastrointestinal bleeding after negative capsule endoscopy. Am J Gastroenterol 2006;101:1224-1228.   DOI   ScienceOn
37 Bar-Meir S, Eliakim R, Nadler M, et al. Second capsule endoscopy for patients with severe iron deficiency anemia. Gastrointest Endosc 2004;60:711-713.   DOI   ScienceOn
38 Semrad CE. Small bowel enteroscopy: territory conquered, future horizons. Curr Opin Gastroenterol 2009;25:110-115.   DOI   ScienceOn
39 Toy E, Rojany M, Sheikh R, Mann S, Prindiville T. Capsule endoscopy's impact on clinical management and outcomes: a single-center experience with 145 patients. Am J Gastroenterol 2008;103:3022-3028.   DOI   ScienceOn
40 Ahmad NA, Iqbal N, Joyce A. Clinical impact of capsule endoscopy on management of gastrointestinal disorders. Clin Gastroenterol Hepatol 2008;6:433-437.   DOI   ScienceOn
41 Hindryckx P, Botelberge T, De Vos M, De Looze D. Clinical impact of capsule endoscopy on further strategy and long-term clinical outcome in patients with obscure bleeding. Gastrointest Endosc 2008;68:98-104.   DOI   ScienceOn
42 Macdonald J, Porter V, McNamara D. Negative capsule endoscopy in patients with obscure GI bleeding predicts low rebleeding rates. Gastrointest Endosc 2008;68:1122-1127.   DOI   ScienceOn
43 Saurin JC, Delvaux M, Vahedi K, et al. Clinical impact of capsule endoscopy compared to push enteroscopy: 1-year follow-up study. Endoscopy 2005;37:318-323.   DOI   ScienceOn
44 Carey EJ, Leighton JA, Heigh RI, et al. A single-center experience of 260 consecutive patients undergoing capsule endoscopy for obscure gastrointestinal bleeding. Am J Gastroenterol 2007;102:89-95.   DOI   ScienceOn
45 Hartmann D, Schmidt H, Bolz G, et al. A prospective two-center study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding. Gastrointest Endosc 2005;61:826-832.   DOI   ScienceOn
46 Raju GS, Gerson L, Das A, et al. American Gastroenterological Association (AGA) Institute technical review on obscure gastrointestinal bleeding. Gastroenterology 2007;133:1697-1717.   DOI   ScienceOn
47 Pennazio M. Bleeding update. Gastrointest Endosc Clin N Am 2006;16:251-266.   DOI   ScienceOn
48 Triester SL, Leighton JA, Leontiadis GI, et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding. Am J Gastroenterol 2005;100:2407-2418.   DOI   ScienceOn
49 Saperas E, Dot J, Videla S, et al. Capsule endoscopy versus computed tomographic or standard angiography for the diagnosis of obscure gastrointestinal bleeding. Am J Gastroenterol 2007;102:731-737.   DOI   ScienceOn