Abstract
Background
Suspected small bowel bleeding (SSBB) is the main indication for videocapsule endoscopy
(VCE) and double balloon enteroscopy (DBE). We assessed the impact of both modalities
in a large cohort of SSBB patients in a European tertiary center.
Methods
We retrospectively evaluated consecutive patients with SSBB undergoing VCE and/or
DBE from March 2001 to July 2020. Demographic/clinical parameters, anticoagulant therapies,
technical characteristics and adverse events were collected, as well as diagnostic
yield (DY), VCE–DBE concordance, hemoglobin (Hb) values before and after DBE, and
complications.
Results
807 VCEs and 407 DBEs were performed in 751 patients. The DY was significantly higher
in DBE compared with VCE (68.8% vs 57.7%), with the highest (75%) yield for overt
active SB bleeding. The agreement between VCE and DBE was generally suboptimal (k = 0.059). This improved in cases where both procedures were done within 1–5 days
of the other (k = 0.323). Post-procedural Hb values were significantly higher. In patients treated
with direct oral anticoagulants (DOACs), there were no differences in DY, complications
or Hb values compared with non-DOAC patients.
Conclusion
VCE and DBE play a pivotal role in the diagnostic and therapeutic approach to SSBB,
having a high clinical impact even in patients treated with DOACs.
Keywords
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Article info
Publication history
Published online: August 07, 2021
Accepted:
July 17,
2021
Received:
April 15,
2021
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.