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Clinical outcome after enteroscopy for small bowel angioectasia bleeding: A Korean Associateion for the Study of Intestinal Disease (KASID) multiceter study

Authors
 Seong Ran Jeon  ;  Jeong‐Sik Byeon  ;  Hyun Joo Jang  ;  Soo Jung Park  ;  Jong Pil Im  ;  Eun Ran Kim  ;  Ja Seol Koo  ;  Bong Min Ko  ;  Dong Kyung Chang  ;  Jin‐Oh Kim  ;  Su Yeon Park  ;  Small Intestine Research Group of the Korean Association for the Study of Intestinal Disease (KASID) 
Citation
 Journal of Gastroenterology and Hepatology, Vol.32(2) : 388-394, 2017 
Journal Title
 Journal of Gastroenterology and Hepatology 
ISSN
 0815-9319 
Issue Date
2017
MeSH
Adult ; Aged ; Balloon Enteroscopy*/adverse effects ; Female ; Gastrointestinal Hemorrhage/etiology* ; Gastrointestinal Hemorrhage/surgery* ; Humans ; Intestine, Small/surgery* ; Liver Cirrhosis/complications ; Male ; Middle Aged ; Multicenter Studies as Topic* ; Recurrence ; Retrospective Studies ; Risk Factors ; Treatment Outcome
Keywords
balloon-assisted enteroscopy ; endotherapy ; obscure gastrointestinal bleeding ; rebleeding
Abstract
BACKGROUND AND AIMS: Angioectasias are the most common sources of bleeding in the small bowel. They can be treated using balloon-assisted enteroscopy (BAE). This study aimed to identify the rebleeding rate and associated factors after BAE in patients with small bowel angioectasia bleeding. METHODS: We retrospectively analyzed the records of patients with bleeding due to small bowel vascular lesion in a multicenter enteroscopy database including 1108 BAEs. Finally, in rebleeding analysis, we analyzed 66 patients with angioectasia on the basis of the Yano-Yamamoto classification. Patients who had undergone endotherapy (ET) were divided into ET (n = 45) and non-ET (n = 21) groups. Rebleeding was defined as evidence of bleeding at least 30 days after BAE. RESULTS: Fifty-three patients (80.4%) underwent only one-side enteroscopy. The most common ET was argon plasma coagulation (87.2%). During a mean follow-up duration of 24.5 months, ET and non-ET groups had rebleeding rates of 15.6% and 38.1% (P = 0.059), respectively. Median rebleeding time of ET and non-ET groups was 32.5 and 62 months, respectively. Liver cirrhosis (LC), low platelet count (< 105 /μL), and transfusions were the rebleeding-associated factors in the univariate analysis. In the multivariate analysis, the presence of LC (HR 4.064, 95% CI 1.098-15.045; P = 0.036) was the only independent rebleeding-associated risk factor. CONCLUSIONS: ET using BAE did not significantly affect the rebleeding rate in patients with small bowel angioectasia bleeding. An independent rebleeding risk factor was the presence of LC. Regardless of ET, careful long-term follow-up may be needed, especially in LC patients with small bowel angioectasia bleeding.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161485
DOI
10.1111/jgh.13479
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
박수정(Park, Soo Jung)
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Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1111/jgh.13479
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