The Value Of Double Balloon Endoscopy In The Diagnosis Of 42 Obscure Gastrointestinal Bleeding Cases

Objective To evaluate the effect of double balloon endoscopy (DBE) in the diagnosis of obscure gastrointestinal bleeding cases.Methods During January 24^th 2007 to March 20^th 2008, 42 patients with obscure gastrointestinal bleeding were examined by DBE.Results In the 42 patients, 29 were examined via mouth, 9 were examined via anus, 4 were examined via both mouth and anus. The observation by DBE showed 30 positive patients, including: tumor 12 (small intestinal interstitial tumor 6, non-Hodgkin's lymphoma 1, lipoma 2, duodenum adenocarcinoma 1, Brunner's adenoma 1, no pathology evidence 1), small intestinal vascular monstrosity 5, small intestinal diverticulum 3, small intestinal polypi 2, Crohn's disease 1, small intestinal mucous membrane erosion 5, duodenum ulcer 1, narrow and inflammatory ileum cavity 1. In the 42 patients, 33 were also examined by abdominal CT. The positive ratio was 48.5%(16/33) and the positive ratio of these 33 patients by DBE was 69.7%(23/33), P>0.05. The combined positive ratio of DBE and CT was 81.8%(27/33). When this result was compared with that of DBE, P>0.05; whereas, compared with that of CT, P<0.05. 28 patients were also examined by capsule endoscopy(CE), the positive ratio was 71.4%(20/28), and the positive ratio of these 28 patients by DBE was 67.9% (19/28), P>0.05, the combined positive ratio of DBE and CE was 92.9% (26/28). When this result was compared with that of DBE, P<0.05; whereas, compared with that of CE, P>0.05. No procedure-related severe adverse events or severe complications such as hemorrhage or perforation occurred in all cases.Conclusion DBE is a safe and reliable diagnostic technique with a high diagnostic yield in obscure gastrointestinal bleeding cases. We suggest that patients with obscure gastrointestinal bleeding should be examined by DBE together with CT and CE.