Korean J Gastrointest Endosc > Volume 41(2); 2010 > Article
Korean Journal of Gastrointestinal Endoscopy 2010;41(2): 79-84.
원인불명 위장관 출혈로 오인된 상하부위장관 출혈의 빈도와 특성
최현숙ㆍ김진오ㆍ김동균ㆍ전성란ㆍ정윤호ㆍ김현건ㆍ이태희ㆍ조원영ㆍ김완중ㆍ고봉민ㆍ이문성ㆍ조주영ㆍ이준성
순천향대학교 의과대학 내과학교실, 소화기연구소
Characteristics of Lesions Misdiagnosed as Obscure Gastrointestinal Bleeding
Hyun Sook Choi, M.D., Jin Oh Kim, M.D., Dong Kyun Kim, M.D., Sung Ran Jeon, M.D., Yoon Ho Jung, M.D.,

Hyun Gun Kim, M.D., Tae Hee Lee, M.D., Won Young Cho, M.D., Wan Jung Kim, M.D., Bong Min Ko, M.D., Moon Sung Lee, M.D., Joo Young Cho,

Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
Abstract

Background/Aims:
Double balloon enteroscopy (DBE) and capsule endoscopy (CE) are useful for evaluation of obscure gastrointestinal bleeding (OGIB). However, many bleeding sources within reach of conventional upper and lower endoscopes can be missed in patients who have undergone DBE and CE for OGIB. The aim of this study was to determine the incidence and characteristics of OGIB lesions within reach of a conventional endoscope in patients undergoing DBE and CE for the indication of OGIB.
Methods:
This retrospective study included 134 patients who were evaluated for OGIB between March 2003 and May 2009 at Soonchunhyang University Hospital.
Results:
Of the 134 patients, 76 underwent CE, 28 patients underwent DBE, and 30 underwent both CE and DBE. The incidence of OGIB lesions within reach of a conventional upper and lower endoscopy was 9.7% (n=13) and the mean age of patients was 51 years (range: 20 to 69 years). The most commonly missed lesion was duodenal ulcer (n=8). The other missed lesions were gastric ulcer (n=2), terminal ileal ulcer (n=2) and ileocecal valve ulcer (n=1).
Conclusions:
The duodenum should be observed closely in initial upper and lower endoscopy by experienced endoscopists. Performing a second EGD and ileocolonoscopy before DBE and CE may increase the diagnostic yield and improve cost-effectiveness in patients with OGIB. (Korean J Gastrointest Endosc 2010;41: 79-84)
Key Words: Obscure gastrointestinal bleeding, Capsule endoscopy, Double balloon enteroscopy
주요어: 원인불명의 위장관 출혈, 캡슐내시경, 이중풍선소장내시경
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