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World J Gastrointest Endosc. Jun 16, 2014; 6(6): 248-253
Published online Jun 16, 2014. doi: 10.4253/wjge.v6.i6.248
Published online Jun 16, 2014. doi: 10.4253/wjge.v6.i6.248
Predictors of double balloon endoscopy outcomes in the evaluation of gastrointestinal bleeding
Hisham Hussan, Section of Intestinal Neoplasia and Hereditary Polyposis (INHP), Department of Gastroenterology, Hepatology and Nutrition, The Ohio State University Medical Center, Columbus, OH 43210, United States
Hisham Hussan, Jennifer L LaBundy, Christine Hachem, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, Saint Louis, MO 63110, United States
Nicholas R Crews, School of Medicine, Saint Louis University School of Medicine, Saint Louis, MO 63104, United States
Caroline M Geremakis, Center for Outcomes Research, Saint Louis University, Saint Louis, MO 63103, United States
Soubhi Bahna, Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, MO 63104, United States
Author contributions: Hussan H conceived and drafted the study, data collection, statistical analysis, wrote and revised the manuscript; Crews NR and Bahna S collected data; Geremakis CM statistically analyzed the data; LaBundy JL and Hachem C drafted study, revised the manuscript.
Correspondence to: Hisham Hussan, MD, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, 3635 Vista Avenue at Grand Blvd, Saint Louis, MO 63110, United States. hhussan@gmail.com
Telephone: +1-314-5778764 Fax: +1-314-5778125
Received: January 15, 2014
Revised: March 5, 2014
Accepted: May 16, 2014
Published online: June 16, 2014
Revised: March 5, 2014
Accepted: May 16, 2014
Published online: June 16, 2014
Core Tip
Core tip: Double balloon endoscopy (DBE) is an excellent tool to visualize the small bowel and provide treatment. However, it may be unable to identify a source for bleeding in 20% to 40% of obscure gastrointestinal bleeding (OGIB) cases. This small retrospective case-control study showed that factors such as fewer blood transfusion requirements, absence of arteriovenous malformations or ulcers on prior endoscopies and possibly endoscopist fatigue may predict a negative diagnostic and therapeutic yield of DBE. This may help manage patients with OGIB and multiple comorbidities and potentially reduce health care costs by classifying patients who are most likely to benefit from this time intensive procedure.