Follow-up after Double Balloon Enteroscopy in Patients with Suspected Small Bowel Bleeding: Focused on the Rebleeding Rate

Boo, Sun Jin; Byeon, Jeong Sik; Choi, Kee Don; Ye, Byong Duk; Yang, Dong Hoon; Yoon, Soon Man; Kim, Kyung Jo; Myung, Seung Jae; Yang, Suk Kyun; Kim, Jin Ho

Abstract

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.