Baek Dong Hoon, Hwang Seonyeong, Eun Chang Soo, Jeon Seong Ran, Kim Jinsu, Kim Eun Ran, Yang Dong-Hoon, Jang Hyun Joo, Im Jong Pil, Park Soo Jung, Jung Sung Hoon
Department of Internal Medicine, Pusan National University School of Medicine, Busan 49421, Korea.
Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Korea.
Diagnostics (Basel). 2021 Oct 10;11(10):1860. doi: 10.3390/diagnostics11101860.
Balloon-assisted enteroscopy (BAE) is an important diagnostic modality for ongoing obscure gastrointestinal bleeding (OGIB). However, it is difficult to determine the optimal insertion route. We retrospectively analyzed the records of patients with OGIB contained in a multicenter enteroscopy database of 1108 balloon-assisted enteroscopy (BAE) procedures (875 patients) to find out factors affecting BAE route selection in patients with OGIB. A total of 603 BAE procedures in 512 patients were investigated: there were 392 (65.0%) bidirectional and 211 (35.0%) unidirectional procedures. Overt OGIB was more frequent in the latter group ( = 0.024). Computed tomography (CT) was more frequently performed in the unidirectional group ( < 0.001). Capsule endoscopy and a small bowel barium study were performed more frequently in the bidirectional group ( < 0.001 and = 0.039, respectively). Multivariate analysis showed that occult OGIB, capsule endoscopy and a small bowel barium study were independently associated with use of the bidirectional approach ( = 0.011, = 0.013 and = 0.046, respectively). Conversely, CT was associated with use of the unidirectional approach ( < 0.001). Conclusion: CT can aid the selection of an optimal insertion route in OGIB patients. However, capsule endoscopy and small bowel barium study are unhelpful.
气囊辅助小肠镜检查（BAE）是诊断持续性不明原因胃肠道出血（OGIB）的重要手段。然而，确定最佳插入路径较为困难。我们回顾性分析了一个多中心小肠镜检查数据库中包含的OGIB患者记录，该数据库有1108例气囊辅助小肠镜检查（BAE）手术（875例患者），以找出影响OGIB患者BAE路径选择的因素。共调查了512例患者的603例BAE手术：其中双向手术392例（65.0%），单向手术211例（35.0%）。显性OGIB在后一组中更为常见（P = 0.024）。单向组更频繁地进行计算机断层扫描（CT）（P < 0.001）。双向组更频繁地进行胶囊内镜检查和小肠钡剂造影（分别为P < 0.001和P = 0.039）。多因素分析显示，隐匿性OGIB、胶囊内镜检查和小肠钡剂造影分别与双向入路的使用独立相关（分别为P = 0.011、P = 0.013和P = 0.046）。相反，CT与单向入路的使用相关（P < 0.001）。结论：CT有助于OGIB患者选择最佳插入路径。然而，胶囊内镜检查和小肠钡剂造影并无帮助。
