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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
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.
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김원호(Kim, Won Ho) ; 김태일(Kim, Tae Il) ; 문창모(Moon, Chang Mo) ; 박재준(Park, Jae Jun) ; 신재국(Shin, Jae Kook) ; 임준석(Lim, Joon Seok) ; 전승민(Jeon, Soung Min) ; 천재희(Cheon, Jae Hee) ; 홍성필(Hong, Sung Pil)
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