Long-term outcomes of patients with obscure gastrointestinal bleeding after negative capsule endoscopy.
J Gastroenterol Hepatol
; 39(1): 165-171, 2024 Jan.
Article
em En
| MEDLINE
| ID: mdl-37837361
ABSTRACT
BACKGROUND AND AIM:
Although small-bowel capsule endoscopy (CE) is widely used for obscure gastrointestinal bleeding (OGIB), long-term outcomes for OGIB patients after negative CE remain unclear. Herein, we defined negative CE as P0 (no bleeding potential) or P1 (less likely to bleed), based on the P classification using CE. We aimed to clarify long-term outcomes of patients with OGIB after negative CE.METHODS:
This single-center observational study enrolled 461 consecutive patients with OGIB who underwent CE from March 2014 to October 2021 and were followed up for >1 year. We examined rebleeding rates and predictive factors.RESULTS:
Two hundred and twenty-four (49%) patients had P0, and 237 (51%) had P1 findings. Rebleeding occurred in 9% and 16% of patients in the P0 and P1 groups, respectively. Two patients in the P0 group and 15 in the P1 group showed rebleeding from the small bowel. The rate of small-bowel rebleeding was significantly lower in the P0 group than that in the P1 group (1% vs 6%, P = 0.002), as was the cumulative rebleeding rate (P = 0.004). In the multivariate analysis, history of endoscopic hemostasis (hazard ratio [HR] = 15.958, 95% confidence interval [CI]4.950-51.447, P < 0.001) and P1 CE findings (HR = 9.989, 95% CI 2.077-48.030, P = 0.004) were independently predicted small-bowel rebleeding.CONCLUSIONS:
OGIB with P0 CE findings rarely showed rebleeding from the small bowel. Rebleeding may occur in patients with OGIB. Patients with history of endoscopic hemostasis for small-bowel lesions or P1 CE findings should be followed up intensively.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hemostase Endoscópica
/
Endoscopia por Cápsula
Limite:
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article