Gastrointestinal bleeding from jejunal and ileal lesions remains undiagnosed using traditional imaging techniques.
Dr Muhammed Hadithi and colleagues from the Netherlands compared diagnostic detection rates of small-bowel lesions.
The research team assessed wireless video capsule endoscopy or double-balloon enteroscopy in patients with obscure gastrointestinal bleeding .
The secondary outcomes assessed by the researchers were tolerance, adverse events, endoscopic interventions, and prognosis.
The team included 35 consecutive patients with obscure gastrointestinal bleeding, of which 22 were male and 13 were female with a mean age of 63 years.
The researchers detected small-bowel abnormalities using video capsule endoscopy in 80% of the patients with obscure gastrointestinal bleeding ,
Using double-balloon enteroscopy, the team detected obscure gastrointestinal bleeding in 60% of the patients.
|Small-bowel abnormalities were found in 80% with endoscopy vs 60% with enteroscopy|
|American Journal of Gastroenterology|
Both examinations were well tolerated, but the researchers observed that video capsule endoscopy was more acceptable to patients.
No major adverse event occurred after either examination.
Biopsies, argon plasma coagulation, tattoo injection, and polypectomy were feasible with double-balloon enteroscopy when indicated in 77% of the patients.
During a median follow-up period of 5 months, 74% of patients remained clinically stable after double-balloon enteroscopy.
The researchers found that these patients did not require blood transfusions after this procedure.
In addition, the team noted that 51% of those who remained clinically stable had received APC therapy.
Dr Hadithi's team concluded, “High detection rates of the causes of obscure gastrointestinal bleeding are feasible with video capsule endoscopy and double-balloon enteroscopy.”
“Although the detection rate of video capsule endoscopy was superior, the results indicate that the procedures are complementary.”
“Initial diagnostic imaging employing video capsule endoscopy might be followed by therapeutic and interventional double-balloon enteroscopy.”