현성 소장 출혈 의심 환자에서 이중풍선 소장내시경 후 추적 관찰: 재출혈률을 중심으로 |
부선진ㆍ변정식ㆍ최기돈ㆍ예병덕ㆍ양동훈ㆍ윤순만ㆍ김경조ㆍ명승재ㆍ양석균ㆍ김진호 |
울산대학교 의과대학 서울아산병원 소화기내과학교실 |
Follow-up after Double Balloon Enteroscopy in Patients with Suspected Small Bowel Bleeding: Focused on the Rebleeding Rate |
Sun-Jin Boo, M.D., Jeong-Sik Byeon, M.D., Kee Don Choi, M.D., Byong Duk Ye, M.D., Dong-Hoon Yang, M.D., Soon Man Yoon, M.D., Kyung-Jo Kim, M.D., Seung-Jae Myung, M.D., Suk-Kyun Yang, M.D. and Jin-Ho Kim, M.D. |
Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea |
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Abstract |
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Background/Aims: Double balloon enteroscopy (DBE) is an effective modality for making the diagnosis and managing suspected small bowel bleeding. However, there is limited data on the follow-up results after DBE. The aim of this study was to evaluate the long-term clinical outcome after DBE in patients with suspected small bowel bleeding.
Methods: We retrospectively analyzed the rebleeding rate of 60 consecutive patients (M:F=39:21, age: 13∼85 years) who underwent DBE because of suspected small bowel bleeding at Asan Medical Center during a 3 year period.
Results: The median follow-up period was 552 days. Bleeding sources were detected by DBE in 41 patients. The cumulative rebleeding rate at 6, 12 and 24 months was 22%, 27% and 30%, respectively. There was no significant difference in the cumulative rebleeding rate between the patients with bleeding sources detected by the initial DBE and those without bleeding sources detected by the initial DBE. The cumulative rebleeding rate at 6 and 12 months was significantly higher for the patients with vascular or superficial mucosal lesions than for the patients with tumors or other lesions (p=0.013).
Conclusions: The rebleeding risk after DBE is not low for patients with suspected small bowel bleeding. The rebleeding risk is especially high for patients with vascular or superficial mucosal lesions, and this may necessitate careful follow-up. (Korean J Gastrointest Endosc 2010;40:157-163) |
Key Words:
Suspected small bowel bleeding, Double balloon enteroscopy, Rebleeding rate |
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