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Long-term outcomes of obscure gastrointestinal bleeding after CT enterography: does negative CT enterography predict lower long-term rebleeding rate?

 Jae Kook Shin  ;  Jae Hee Cheon  ;  Joon Seok Lim  ;  Jae Jun Park  ;  Chang Mo Moon  ;  Soung Min Jeon  ;  Jin Ha Lee  ;  Sung Pil Hong  ;  Tae Il Kim  ;  Won Ho Kim 
 Journal of Gastroenterology and Hepatology, Vol.26(5) : 901-907, 2011 
Journal Title
 Journal of Gastroenterology and Hepatology 
Issue Date
Adult ; Aged ; Anemia/etiology ; Contrast Media* ; Electrolytes* ; Female ; Gastrointestinal Hemorrhage/diagnostic imaging* ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/therapy ; Humans ; Kaplan-Meier Estimate ; Male ; Melena/etiology ; Middle Aged ; Polyethylene Glycols* ; Predictive Value of Tests ; Recurrence ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sensitivity and Specificity ; Time Factors ; Tomography, X-Ray Computed* ; Treatment Outcome
computed tomography enterography ; long-term outcome ; obscure gastrointestinalbleeding
BACKGROUND AND AIM: Computed tomography enterography (CTE) is a promising modality for small bowel imaging. However, the role of CTE in the evaluation of obscure gastrointestinal bleeding (OGIB) has not been established. We investigated the efficacy of CTE in diagnosing OGIB and the long-term outcomes based on CTE findings, with special reference to negative CTE. METHODS: A total of 63 consecutive patients who had undergone CTE for OGIB were enrolled, and their pre- and post-CTE clinical data were collected. "Specific treatments" were defined as treatments directly aimed at resolving presumed bleeding causes, including hemostasis and operation, while "non-specific treatments" were defined as symptomatic treatments for anemia. RESULTS: Among 60 patients for whom long-term follow-up data were available, positive lesions were found in 16 patients (26.7%). The overall rebleeding rate was 21.7% during a mean follow up of 17.6 ± 4.7 months. There was no significant difference in the cumulative rebleeding rates between patients with positive and negative CTE results (P = 0.241). All patients who received specific treatments after CTE did not rebleed (0/8). In positive CTE patients, specific treatments significantly reduced the rebleeding rate (P = 0.023). CONCLUSIONS: CTE has a high rate of detecting overt OGIB. However, negative CTE results do not predict lower long-term rebleeding, and such patients with OGIB should be closely observed. In patients with positive CTE, more vigorous management significantly reduces the incidence of rebleeding.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Moon, Chang Mo(문창모)
Park, Jae Jun(박재준)
Shin, Jae Kook(신재국)
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Jeon, Soung Min(전승민)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
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