Timing, timing, timing of deep enteroscopy! A key factor for diagnosis of small intestinal hemorrhage, but does it impact patient outcomes?

摘要

Obscure gastrointestinal hemorrhage is defined as failure to locate a source of bleeding during standard upper and lower endoscopic examinations. Although patients with obscure gastrointestinal hemorrhage account for only 5% of patients presenting with gastrointestinal hemorrhage, these patients incur significant costs, hospital-izations, medical testing, and impact on health-related quality of life (Gastroenterology 2007;133:1697-1717). Video capsule endoscopy (VCE), introduced in the United States in 2000, allows for a noninvasive means of total small bowel visualization (Gastrointest Endosc 2000;52: 817-819). Double balloon enteroscopy (DBE), described initially by Dr Yamamoto in 2000 and introduced in the United States in 2004, provides the possibility for total small bowel enteroscopy (Gastrointest Endosc 2001;53: 216-220). DBE was followed by introduction of single balloon and spiral enteroscopy in the United States in 2007.