|Title:||Early timing of single balloon enteroscopy is associated with increased diagnostic yield in patients with overt small bowel bleeding||Authors:||Tu C.-H.
|Issue Date:||2019||Publisher:||Elsevier B.V.||Journal Volume:||118||Journal Issue:||12||Start page/Pages:||1644-1651||Source:||Journal of the Formosan Medical Association||Abstract:||
Background/purpose: Although performing balloon enteroscopy soon after the onset of small bowel bleeding appeared to enhance diagnostic rate, the optimal timing was unclear. Methods: A retrospective cohort study in a single referral center. Patients with overt, suspected small bowel bleeding who underwent primary single-balloon enteroscopy (SBE) were evaluated to determine the association between procedure timing and diagnostic yield rates. Results: A total of 220 patients were enrolled (47.7% males; mean age, 65.6 ± 18.1 years). They were stratified into four groups based on the timing of SBE: emergency (<24 h after onset or continued bleeding, n = 64), 24–72 h (n = 28), 3–7 days (n = 41), and >7 days (n = 87). A significant trend of decreasing diagnostic yields was observed across the groups (90.6%, 67.9%, 68.3%, and 44.8%, respectively, P < 0.0001). Diagnostic yield rates were different between emergency and 24–72 h groups (P < 0.0001), and between 3 and 7 days and >7 days groups (P < 0.05), but not between 24 and 72 h and 3–7 days groups (P = 0.97). In multivariate regression analysis, emergency, ? 3 days, and ?7 days SBEs had greater yield rates than SBEs at later timings. Conclusion: The likelihood of diagnostic yield was highest when SBE was performed during continued bleeding or within 24 h of onset, and gradually declined as waiting time increased. We therefore recommend that SBE should be performed as soon as possible, preferably no later than seven days. ? 2019
|ISSN:||0929-6646||DOI:||10.1016/j.jfma.2019.01.003||metadata.dc.subject.other:||adult; aged; Article; bleeding tendency; cohort analysis; Crohn disease; diagnostic value; emergency; enteritis; enteropathy; female; hookworm infection; human; ileitis; intestine diverticulosis; intestine ulcer; major clinical study; male; Mallory Weiss syndrome; middle aged; petechia; portal hypertension; retrospective study; sepsis; single balloon enteroscopy; small intestine hemorrhage; small intestine perforation; small intestine tumor; thermocoagulation; time; vascular lesion; very elderly; gastrointestinal hemorrhage; multivariate analysis; pathology; small intestine; statistical model; time factor; Aged; Aged, 80 and over; Female; Gastrointestinal Hemorrhage; Humans; Intestine, Small; Logistic Models; Male; Middle Aged; Multivariate Analysis; Retrospective Studies; Single-Balloon Enteroscopy; Time Factors
|Appears in Collections:||醫學系|
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