Estevinho Maria Manuela, Pinho Rolando, Rodrigues Adélia, Ponte Ana, Afecto Edgar, Correia João, Freitas Teresa
Department of Gastroenterology, Vila Nova de Gaia/Espinho Hospital Center, 4400-129 Vila Nova de Gaia, Portugal.
Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
Diagnostics (Basel). 2022 Nov 4;12(11):2685. doi: 10.3390/diagnostics12112685.
Evidence for an urgent approach to ongoing overt suspected small-bowel bleeding (SSBB) is scarce. We aimed to analyze our series of urgent small-bowel capsule endoscopies (SBCEs) for ongoing overt SSBB and to identify factors associated with positive findings and outcomes. A retrospective study of all SBCEs performed in the first 48 h after admission for overt SSBB between January 2006 and February 2022 was performed. Descriptive and inferential analyses (univariate and multivariable) were performed. Eighty-three urgent SBCEs were performed for overt SSBB. Patients were mostly men (69.2%, median age 68) and were followed for a median of 58.2 months (range 5-176). The diagnostic yield was 80.7%; in 60.2%, blood was detected in the small bowel (SB), while in 50.6%, a bleeding lesion was identified, mostly angioectasia. Patients with diabetes mellitus or taking NSAIDs were more prone to present SB findings, yet the explanatory power was low. Endoscopic or surgical treatments were performed in 28.9% and 19.3%, respectively, with the "non-conservative" therapeutic yield being 56.6%. Rebleeding occurred in 20.5% and was associated in the multivariable analysis with the female gender and anticoagulants use. This cohort of urgent SBCE, the largest from a European center, reinforces the usefulness of SBCE for ongoing overt SSBB management. This prompt performance of this procedure is highly effective, regardless of patients' features.
对于持续存在的明显疑似小肠出血（SSBB）采取紧急处理方法的证据很少。我们旨在分析我们针对持续存在的明显SSBB进行的一系列紧急小肠胶囊内镜检查（SBCE），并确定与阳性发现和结果相关的因素。对2006年1月至2022年2月期间因明显SSBB入院后48小时内进行的所有SBCE进行了回顾性研究。进行了描述性和推断性分析（单变量和多变量）。对明显SSBB进行了83次紧急SBCE。患者大多为男性（69.2%），中位年龄68岁，中位随访时间为58.2个月（范围5 - 176个月）。诊断率为80.7%；在60.2%的患者中，在小肠（SB）中检测到血液，而在50.6%的患者中，发现了出血病变，主要是血管扩张。患有糖尿病或服用非甾体抗炎药的患者更易出现小肠检查结果，但其解释力较低。分别有28.9%和19.3%的患者接受了内镜或手术治疗，“非保守”治疗率为56.6%。再出血发生率为20.5%，多变量分析显示其与女性性别和使用抗凝剂有关。这组来自欧洲中心的最大规模的紧急SBCE队列，强化了SBCE在持续存在的明显SSBB管理中的有用性。无论患者特征如何，该检查的及时进行都非常有效。
