Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
Turk J Gastroenterol. 2020 Oct;31(10):688-694. doi: 10.5152/tjg.2020.19387.
BACKGROUND/AIMS: This study aimed to investigate the feasibility, efficiency, and clinical significance of examining the total gastrointestinal (GI) tract by consecutive bidirectional double-balloon enteroscopy (DBE) within 1 day in patients with suspected small-bowel bleeding.
From January 2016 to January 2018, the clinical and endoscopic data of 41 patients with suspected small-bowel bleeding undergoing DBE aimed at inspecting the total GI tract within 1 day.
A success rate of 87.8% (36/41) for examining the total GI tract with no adverse event was achieved by consecutive bidirectional DBE performed within 1 day. The total examination time was 140.61±36.41 (range, 82-270) minutes. Positive or negative findings of bleeding were detected in 51.2% (21/41) and 48.8% (20/41) patients, respectively. Single bleeding etiology with non-small-bowel lesions (NSBLs) or small-bowel lesions (SBLs) was detected in 12.2% (5/41) and 26.8% (11/41) of patients, respectively. Dual bleeding etiologies, including NSBLs and SBLs, were detected in 12.2% (5/41) of patients. A re-bleeding rate of positive or negative findings was different (4.8% vs. 40.0%; p<0.05).
Consecutive bidirectional DBE within 1 day can achieve complete vision of the total GI tract with a considerable success rate and high safety. This strategy may provide an option for detecting bleeding etiology throughout the GI tract. A negative finding with this method cannot absolutely exclude missed bleeding etiology and re-bleeding.
背景/目的：本研究旨在探讨在疑似小肠出血患者中，于 1 日内连续行双向双气囊小肠镜（DBE）检查整个胃肠道（GI）的可行性、效率和临床意义。
2016 年 1 月至 2018 年 1 月，41 例疑似小肠出血患者行 DBE 检查，旨在 1 日内检查整个 GI 道。
41 例患者中，36 例（87.8%）在 1 日内连续行双向 DBE 检查成功，无不良事件发生，检查总时间为 140.61±36.41（82-270）分钟。51.2%（21/41）和 48.8%（20/41）的患者分别发现阳性或阴性出血。12.2%（5/41）和 26.8%（11/41）的患者分别发现单一出血病因，包括非小肠病变（NSBLs）或小肠病变（SBLs），12.2%（5/41）的患者发现双重出血病因，包括 NSBLs 和 SBLs。阳性或阴性发现的再出血率不同（4.8%比 40.0%；p<0.05）。
1 日内连续行双向 DBE 可实现整个 GI 道的完整观察，成功率高，安全性好。这种策略可能为整个 GI 道的出血病因检测提供一种选择。这种方法的阴性发现不能绝对排除遗漏的出血病因和再出血。
