Volume 19 Issue 8
Aug.  2021
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DIAO Lei, HONG Ru-tao, HAN Wei, HU Jing, CHEN Xi. Clinical application of CT enterography and double-balloon enteroscopy in the diagnosis of suspected small intestinal bleeding[J]. Chinese Journal of General Practice, 2021, 19(8): 1347-1350. doi: 10.16766/j.cnki.issn.1674-4152.002057
Citation: DIAO Lei, HONG Ru-tao, HAN Wei, HU Jing, CHEN Xi. Clinical application of CT enterography and double-balloon enteroscopy in the diagnosis of suspected small intestinal bleeding[J]. Chinese Journal of General Practice, 2021, 19(8): 1347-1350. doi: 10.16766/j.cnki.issn.1674-4152.002057

Clinical application of CT enterography and double-balloon enteroscopy in the diagnosis of suspected small intestinal bleeding

doi: 10.16766/j.cnki.issn.1674-4152.002057
Funds:

 201904a07020043

  • Received Date: 2020-12-28
    Available Online: 2022-02-16
  •   Objective  The clinical data of patients with suspected small bowel bleeding in our hospital were analyzed retrospectively to explore the application value of CT enterography (CTE) and double-balloon enteroscopy (DBE) in the diagnosis of suspected small bowel bleeding.  Methods  The clinical data of 54 patients with suspected small bowel bleeding hospitalized in the Department of Gastroenterology of the First Affiliated Hospital of Anhui Medical University from October 2019 to October 2020 were analyzed retrospectively. The positive results of CTE and DBE in the diagnosis of suspected small bowel bleeding and the cases of complications were counted. The results were counted by the 2 test or exact probability method of Fisher test. The diagnostic rate and complication rate of intestinal hemorrhage were compared by CTE and DBE, and the diagnostic value and safety of CTE and DBE were discussed.  Results  All the 54 patients completed CTE and DBE examination, with a success rate of 100%. The lesions mainly included diverticulum, ulcer, vasodilation, tumor and Crohn's disease. The diagnosis rate of lesions by CTE was 53.7% (29/54) compared with 79.6% (43/54) by DBE and the difference was significant (χ2=8.167, P < 0.01). In terms of safety comparison, there was no complications in all patients who underwent CTE examination (0/54). However, the incidence of complications in 54 patients examined by DBE was only 1 case, and the incidence of complications was 1.9% (1/54). No significant difference was observed in the incidence of complications between CTE and DBE (P>0.05).  Conclusion  The diagnostic rate of DBE in small bowel bleeding is significantly higher than that of CTE, and without serious complications. The diagnostic rate of CTE for ulcer and vasodilation is not high, but it is sensitive to diverticulum, tumor and Crohn's disease. CTE combined with DBE examination can effectively avoid missed diagnosis of small bowel bleeding.

     

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  • [1]
    ZAMMIT S C, SIDHU R. Small bowel bleeding: Cause and the role of endoscopy and medical therapy[J]. Curr Opin Gastroenterol, 2018, 34(3): 165-174. doi: 10.1097/MOG.0000000000000429
    [2]
    ASGE STANDARDS OF PRACTICE COMMITTEE. The role of endoscopy in the management of suspected small-bowelbleeding[J]. Gastrointest Endosc, 2017, 85(1): 22-31. doi: 10.1016/j.gie.2016.06.013
    [3]
    OHMIYA N. Management of obscure gastrointestinal bleeding: Comparison of guidelines between Japan and other countries[J]. Dig Endosc, 2020, 32(2): 204-218. doi: 10.1111/den.13554
    [4]
    KUO J R, PASHA S F, LEIGHTON J A. The clinician's guide to suspected small bowel bleeding[J]. Am J Gastroenterol, 2019, 114(4): 591-598. doi: 10.1038/s41395-018-0424-x
    [5]
    占俊, 汤进芝, 汪文生, 等. 不同剂型聚乙二醇电解质在结肠镜检查前肠道准备中的应用比较[J]. 中华全科医学, 2020, 18(8): 1283-1286. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202008011.htm
    [6]
    KUSHNIR V M, TANG M, GOODWIN J, et al. Long-term outcomes after single-balloon enteroscopy in patients with obscure gastrointestinal bleeding [J]. Dig Dis Sci, 2013, 58(9): 2572-2579. doi: 10.1007/s10620-013-2588-y
    [7]
    OTANI K, WATANABE T, SHIMADA S, et al. Clinical utility of capsule endoscopy and double-balloon enteroscopy in the management of obscure gastrointestinal bleeding[J]. Digestion, 2018, 97(1): 52-58. doi: 10.1159/000484218
    [8]
    GERSON L B. Small bowel bleeding: Updated algorithm andoutcomes[J]. Gastrointest Endosc Clin N Am, 2017, 27(1): 171-180. doi: 10.1016/j.giec.2016.08.010
    [9]
    HASHIMOTO R, NAKAHORI M, MATSUDA T. Impact of urgent double-balloon enteroscopy on the short-term and long-term outcomes in overt small bowel bleeding[J]. Dig Dis Sci, 2019, 64(10): 2933-2938. doi: 10.1007/s10620-019-05627-1
    [10]
    SONG J H, HONG S N, CHANG D K, et al. The etiology of potential small-bowel bleeding depending on patient's age and gender[J]. United European Gastroenterol J, 2018, 6(8): 1169-1178. doi: 10.1177/2050640618797841
    [11]
    曹皓阳, 高青. 原发性小肠淋巴瘤诊治研究进展[J]. 现代医药卫生, 2020, 36(14): 2202-2205. https://www.cnki.com.cn/Article/CJFDTOTAL-XYWS202014022.htm
    [12]
    DEEPAK P, PUNDI K N, BRUINING D H, et al. Multiphase computed tomographic enterography: Diagnostic yield and efficacy in patients with suspected small bowel bleeding[J]. Mayo Clin Proc Innov Qual Outcomes, 2019, 3(4): 438-447. doi: 10.1016/j.mayocpiqo.2019.09.001
    [13]
    HE B, YANG J, XIAO J, et al. Accuracy of computed tomographic enterography for obscure gastrointestinal bleeding: A diagnostic meta-analysis[J]. Acad Radiol, 2018, 25(2): 196-201. doi: 10.1016/j.acra.2017.09.001
    [14]
    中华消化杂志编辑委员会. 小肠出血诊治专家共识意见[J]. 中华消化杂志, 2018, 38(9): 577-582. doi: 10.3760/cma.j.issn.0254-1432.2018.09.001
    [15]
    郭志国, 彭炤源, 辛毅, 等. 双气囊小肠镜在小肠出血患者治疗中的应用价值及安全性研究[J]. 中国内镜杂志, 2017, 23(1): 103-106. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGNJ201701022.htm
    [16]
    HASHIMOTO R, MATSUDA T, NAKAHORI M. False-negative double-balloon enteroscopy in overt small bowel bleeding: Long-term follow-up after negative results[J]. Surg Endosc, 2019, 33(8): 2635-2641. doi: 10.1007/s00464-018-6561-x
    [17]
    YIN A, ZHAO L, DING Y, et al. Emergent double balloon enteroscopy in overt suspected small bowel bleeding: Diagnosis and therapy[J]. Med Sci Monit, 2020, 26: e920555. http://www.researchgate.net/publication/338755087_Emergent_Double_Balloon_Enteroscopy_in_Overt_Suspected_Small_Bowel_Bleeding_Diagnosis_and_Therapy
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