Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 21, 2012; 18(7): 692-697
Published online Feb 21, 2012. doi: 10.3748/wjg.v18.i7.692
Clinical impact of multidetector computed tomography before double-balloon enteroscopy for obscure gastrointestinal bleeding
Hsu-Heng Yen, Yang-Yuan Chen, Chia-Wei Yang, Chi-Kuang Liu, Maw-Soan Soon
Hsu-Heng Yen, Chia-Wei Yang, Maw-Soan Soon, Department of Gastroenterology, Endoscopy Center, Changhua Christian Hospital, 500 Changhua, Taiwan, China
Yang-Yuan Chen, Department of Gastroenterology, China Medical University Hospital, 40402 Taichung, Taiwan, China
Chi-Kuang Liu, Department of Radiology, Changhua Christian Hospital, 500 Changhua, Taiwan, China
Author contributions: Yen HH and Chen YY performed the majority of the double-balloon enteroscopy procedures and contributed equally to the writing and final approval of this manuscript; Yang CW, Liu CK and Soon MS perform the analysis of this study and final approval of this manuscript.
Correspondence to: Hsu-Heng Yen, Dr., Department of Gastroenterology, Endoscopy Center, Changhua Christian Hospital, No. 135 Nanhsiao Street, 500 Changhua, Taiwan, China. 91646@cch.org.tw
Telephone: +886-4-7238595 Fax: +886-4-7228289
Received: January 30, 2011
Revised: April 26, 2011
Accepted: May 2, 2011
Published online: February 21, 2012
Abstract

AIM: To evaluate the clinical impact of multidetector computed tomography (MDCT) before double-balloon endoscopy (DBE) for patients with obscure gastrointestinal bleeding (OGIB).

METHODS: A retrospective analysis of prospectively collected cases with DBE and MDCT for overt OGIB was conducted from April 2004 to April 2010 at Changhua Christian Hospital. We evaluated the clinical impact of MDCT on the subsequent DBE examinations and the diagnostic yields of both MDCT and DBE respectively.

RESULTS: From April 2004 to April 2010, a total of 75 patients underwent DBE for overt OGIB. Thirty one cases received MDCT followed by DBE for OGIB. The overall diagnostic yields of DBE and MDCT was 93.5% and 45.2%. The MDCT had a high diagnostic yield of tumor vs non-tumor etiology of OGIB (85.7% vs 33.3%, P = 0.014). Additionally, the choice of initial route of DBE was correct in those with a positive MDCT vs negative MDCT (100% vs 52.9%, P = 0.003).

CONCLUSION: This study suggests MDCT as a triage tool may identify patients who will benefit from DBE and aid the endoscopist in choosing the most efficient route.

Keywords: Multidetector computed tomography, Capsule endoscopy, Double-balloon endoscopy, Obscure gastrointestinal bleeding