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KMID : 0359020100410020079
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Korean Journal of Gastrointestinal Endoscopy
2010 Volume.41 No. 2 p.79 ~ p.84
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Characteristics of Lesions Misdiagnosed as Obscure Gastrointestinal Bleeding
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Choi Hyun-Sook
Kim Jin-Oh
Kim Dong-Kyun
Jeon Seong-Ran
Jung Yun-Ho
Kim Hyun-Gun
Lee Tae-Hee
Cho Won-Young
Kim Wan-Jung
Ko Bong-Min
Lee Moon-Sung
Cho Joo-Young
Lee Joon-Seong
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Abstract
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Backgrounds/Aims: Double balloon enteroscopy (DBE) and capsule endoscopy (CE) are useful for evaluation of obscure gastrointestinal bleeding (OGIB). However, many bleeding sources within reach of conventional upper and lower endoscopes can be missed in patients who have undergone DBE and CE for OGIB. The aim of this study was to determine the incidence and characteristics of OGIB lesions within reach of a conventional endoscope in patients undergoing DBE and CE for the indication of OGIB.
Methods: This retrospective study included 134 patients who were evaluated for OGIB between March 2003 and May 2009 at Soonchunhyang University Hospital.
Results: Of the 134 patients, 76 underwent CE, 28 patients underwent DBE, and 30 underwent both CE and DBE. The incidence of OGIB lesions within reach of a conventional upper and lower endoscopy was 9.7% (n=13) and the mean age of patients was 51 years (range: 20 to 69 years). The most commonly missed lesion was duodenal ulcer (n=8). The other missed lesions were gastric ulcer (n=2), terminal ileal ulcer (n=2) and ileocecal valve ulcer (n=1).
Conslusions: The duodenum should be observed closely in initial upper and lower endoscopy by experienced endoscopists. Performing a second EGD and ileocolonoscopy before DBE and CE may increase the diagnostic yield and improve cost-effectiveness in patients with OGIB.
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KEYWORD
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Obscure gastrointestinal bleeding, Capsule endoscopy, Double balloon enteroscopy
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