Long-Term Outcomes of Obscure Gastrointestinal Bleeding after CT Enterography: Does Negative CT Enterography Predict Lower Long -Term Rebleeding Rate?
J Gastroenterol Hepatol. 2010 Nov 15;
Authors: Shin JK, Cheon JH, Lim JS, Park JJ, Moon CM, Jeon SM, Lee JH, Hong SP, Kim TI, Kim WH
Background and Aim: CT enterography (CTE)is a promising modality for imaging the small bowel. 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 "nonspecific 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.
PMID: 21073673 [PubMed - as supplied by publisher]