Aniwan Satimai, Viriyautsahakul Vichai, Angsuwatcharakon Phonthep, Kongkam Pradermchai, Treeprasertsuk Sombat, Rerknimitr Rungsun, Kullavanijaya Pinit
Hepatogastroenterology. 2014 Oct;61(135):1990-4.
BACKGROUND/AIMS: Urgent video capsule endoscopy (VCE) and urgent double-balloon endoscopy (DBE) provide high diagnostic yields in overt obscure gastrointestinal bleeding (OGIB). However, no studies have specifically compared VCE and DBE in massive OGIB. The aim of this study was to compare the diagnostic yield and clinical outcomes of the two approaches.
Between October 2010 and March 2013, there were 1,672 consecutive patients with gastrointestinal bleeding and 30 massive OGIB were identified. After non-diagnostic EGD and colonoscopy, VCE and DBE were performed in tandem within 72hr after hospitalization.
Of these, 30 patients were identified as massive OGIB. DBE identified more bleeding lesions than VCE (26(87%) vs. 18(60%), p<0.05). Only DBE was positive in 8 patients (27%). No patient had positive VCE and negative DBE. VCE demonstrated only fresh blood without identifiable lesions in 8 (27%) patients, and all had bleeding lesions identified subsequently by DBE. The number of patients with therapeutic intervention guided by DBE was higher than those with VCE-guided intervention (17(57%) vs. 11(37%); p<0.05). Four patients (13%) had a negative study by both tests, and no further bleeding was reported.
In massive OGIB, urgent DBE had a higher diagnostic yield than VCE. (ClinicalTrials.gov number, NCT01654770)
背景/目的：急诊视频胶囊内镜检查（VCE）和急诊双气囊内镜检查（DBE）在显性不明原因胃肠道出血（OGIB）中具有较高的诊断率。然而，尚无研究专门比较VCE和DBE在大量OGIB中的应用。本研究的目的是比较这两种方法的诊断率和临床结果。
2010年10月至2013年3月期间，连续纳入1672例胃肠道出血患者，其中30例为大量OGIB。在非诊断性上消化道内镜检查（EGD）和结肠镜检查后，住院72小时内先后进行VCE和DBE检查。
这30例患者被确定为大量OGIB。DBE发现的出血病变比VCE多（26例（87%）对18例（60%），p<0.05）。仅DBE检查阳性的患者有8例（27%）。没有患者VCE阳性而DBE阴性。8例（27%）患者VCE仅显示新鲜血液但未发现可识别病变，所有这些患者随后均经DBE发现出血病变。DBE引导下进行治疗干预的患者数量高于VCE引导下干预的患者（17例（57%）对11例（37%）；p<0.05）。4例患者（13%）两种检查均为阴性，未再出现出血情况。
在大量OGIB中，急诊DBE的诊断率高于VCE。（ClinicalTrials.gov编号，NCT01654770）
