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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2020; 11(04): 258-262
DOI: 10.1055/s-0040-1721552
Research Article

Therapeutic Impact of Deep Balloon-assisted Small Bowel Enteroscopy on Red Blood Cell Transfusion

Amandeep S. Kalra
1   Division of Gastroenterology and Hepatology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, United States
,
Andrew J. Walker
2   SSM Health System–Dean Medical Group, Madison, Wisconsin, United States
,
Mark E. Benson
1   Division of Gastroenterology and Hepatology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, United States
,
Nalini M. Guda
3   Division of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin, GI Associates - Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, United States
,
Anurag Soni
1   Division of Gastroenterology and Hepatology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, United States
,
Mehak Misha
4   Gundersen Hospitals and Clinics, La Crosse, Wisconsin, United States
,
Deepak V. Gopal
1   Division of Gastroenterology and Hepatology, Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, United States
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Abstract

Objective Evaluate impact of balloon-assisted deep small bowel enteroscopy on red blood cell transfusion requirement in patients with obscure gastrointestinal (GI) bleeding.

Methods Retrospective study of patients, who underwent balloon-assisted deep enteroscopy with double-balloon enteroscopy (DBE) at two tertiary care academic centers (University of Wisconsin and Aurora St. Luke’s Medical Center) over a 55-month consecutive period. Sixty-nine patients with reliable blood transfusion records were identified during this time period. DBE was preceded by small bowel capsule endoscopy (CE) within 1 year in 38 cases. Transfusion requirements 6 months prior and postintervention were measured to see if DBE had any impact on the need for blood transfusions.

Results Sixty-nine patients (25 females and 44 males) were included. Mean age ± standard deviation (SD) was 63 ± 17 years. Wilcoxon signed rank test statistics were used to find the difference in the rate of blood transfusion. There was a statistically significant decrease in rate of packed red blood cell (pRBC) transfusion post DBE and endoscopic therapy with coagulation (p < 0.001). Argon plasma coagulation was used to ablate all arteriovenous malformations (AVMs) except in one (subepithelial lesion). Those that required > 5 units pRBC transfusions pre-DBE had the most benefit.

Conclusions Our study demonstrates that transfusion requirements are significantly reduced in those undergoing therapy with DBE and coagulation for obscure GI bleed.

Keywords

DBE–double-balloon enteroscopy - OGIB–obscure gastrointestinal bleeding - red blood transfusion - therapeutic endoscopy


Publikationsverlauf

Artikel online veröffentlicht:
28. Dezember 2020

© 2020. Society of Gastrointestinal Endoscopy of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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