The rebleeding rate in patients evaluated for obscure gastrointestinal bleeding after negative small bowel findings by device assisted enteroscopy

• Catarina Gomes ^[2] ; José María Rubio Mateos ^[1] ; Rolando Taveira Pinho ^[2] ; Ana Ponte ^[2] ; Adélia Rodrigues ^[2] ; Margarita Fosado Gayosso ^[1] ; Pilar Esteban Delgado ^[1] ; João Carlos Silva ^[2] ; Edgar Afecto ^[2] ; João Carvalho ^[2]
  1. [1] Hospital Morales Meseguer

     Hospital Morales Meseguer

     Murcia, España

     
  2. [2] Centro Hospitalar Vila Nova de Gaia/Espinho. Gaia, Portuga
• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 112, Nº. 4, 2020, págs. 262-268
• Idioma: inglés
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• Resumen

  • Background: data on the long-term outcome of patients with obscure gastrointestinal bleeding (OGIB) with positive small bowel findings in capsule endoscopy but negative small bowel findings in device-assisted enteroscopy are scarce. Objective: this study aimed to evaluate the rebleeding rate and time to rebleed in patients with no small bowel findings in enteroscopy, after a positive capsule endoscopy in the setting of OGIB. Baseline predictors for rebleeding were assessed. Methods: a retrospective double-center study was performed, including patients with OGIB with positive findings by capsule endoscopy and negative small bowel findings by enteroscopy. Results: thirty-five patients were included. Rebleeding occurred in 40 % of patients during a median follow-up of 27 months. Further evaluation in patients with a rebleed was performed in 85.7 %, leading to a final diagnosis in 78.6 %. The rebleeding rate increased progressively over time, from 17.2 % at one month to 54.4 % at four years. Overt bleeding at the time of the first episode was a predictor of rebleeding (p = 0.03) according to the multivariate analysis. This was 50 % at one year compared with 21.8 % in patients with occult bleeding on admission. Conclusions: in obscure gastrointestinal bleeding, long-term follow-up and further evaluation may be considered after a positive capsule endoscopy. Even if there are no small bowel findings by device-assisted enteroscopy. The rebleeding rate in our study was 40 %, mainly in the presence of an overt bleeding on admission.