Small Bowel Enteroscopy, Capsule Endoscopy And CT Ente Rography In The Study Of The Treatment Of OGIB

Backgroud and ObjectiveBackgroud: Obscure gastrointestinal bleeding due to the multiple caused by intestinaldisease. The small bowel (SB) is the longest organ in human body and its parts hidden,traditional imaging techniques could not get satisfied results for the diagnosis becauseits low detection. So the confirmative diagnosis and treatment of intestinal diseasebecome difficulty. Since the advent of the small bowel enteroscopy (double balloonendoscopy/single balloon enteroscopy).It can direct observation of the small intestinal mucosa, histologic examination and endoscopic treatment. CT enterography can clearthe part of the lesions, the thickness of the tube wall and the relationship of otherorgans. The emergence of the above two methods of checking endoscopy technologyinvention at the beginning of the21st century, they provide a convenient diagnosticmethod for the intestinal diseases.Objective: To explore the etiology, clinical feature of gastrointestinal bleeding and the diagnostic value of double-balloon enteroscopy, capsule endoscopy and CT enterography.Methods：One hundred and thirty-four of patients(including83cases of men and51cases of women) were performed single balloon enteroscopy. The route of enteroscopycould be underwent either via mouth or via anus depends on their clinicalmanifestations. If not found positive results, you can examination for another via, mouthor anus. There are37patients accept the examination both the mouth and anus. And onehundred and seventeen patients (including72cases of men and45cases of women)were performed capsule endoscopy, one hundred and fourteen patients (including71cases of men and43cases of women) were performed CT enterography. Among thecases, sixteen patients were performed both SBE and CE. Twenty patients wereperformed both SBE and CTE.Results:1. One hundred and eight focus of infections were detected in SBE group. Thedetection rate of the positive lesion is80.6%(108/134).Polypus, mucosal breaks(erosions and ulcerations), space occupying lesion, Crohn’s disease, diverticulum,angiodysplasia,small bowel stromal tumors detected in15.7%(21/134),20.1%(27/134),10.4%(14/134),10.4%(14/134),10.4%(14/134),5.2%(7/134),4.8%(6/134), respectively. One hundred and seventeen focus of infections were detected in CE group. The detection rate of the positive lesion is85.5%(100/117).Small mucosal breaks (erosions and ulcerations), polypus, intestinal lymphangiectasia,angiodysplasia,small intestine xanthoma, small intestine apophysis lesions,small bowel diverticular,small intestinal roundworm disease,space occupying lesion, crohn’s disease w ere detected in38.5%(45/117),7.7%(9/117),11.1%(13/117),8.5%(10/117),7.7%(9/117),6.8%(8/117) patients, respectively. Fifty five focus of infections were detectedin CTE group. The detection rate of the positive lesion is48.2%(55/114). Small intestinal inflammatory change, crohn’s disease, small intestine polypoid changeand small bowel diverticular, suspected crohn’s disease, neoplasm and lipomyoma were detected in34.2%(39/114),7.9%(9/114)patients, respectively.2. The diagnostic yield for SBE, CE, and CTE group was80.6%,85.5%, and48.2%respectively. The etiological diagnostic accuracy of SBE, CE, and CTE group was78.4%,59.8%, and13.2%respectively.Sixteen patients were performedboth SBE and CE,the positive lesion detection rate of them have no difference.Twenty patients were performed both SBE and CTE, the positive lesion detection rate of SBE is higher than CTE.3. Sixteen patients were performed both SBE and CE. Four of them obtain thesame conclusion. Twenty patients were performed both SBE and CTE. Ten of them obtain the same conclusion. The CTE is an important method of examination, it can clear the thickness of tube wall and the relationship between the adjacent organs, it plays a prompt action for the diagnosis of crohn’s disease.4. The SBE group and CTE group patients were well tolerated, and had no adverse reactions and complication.Four case of CE group had complication happened.Conclusions1. The most common causes of OGIB are polyps and small balloon mucosal breaks,such as ulcerations and erosions.2. The diagnostic yield of CE is higher than SBE, there was no statistically significant difference between them.(P>0.05)3. The CTE is an important method of examination, and as a complementary examination to OGIB, it plays a prompt action for the diagnosis of crohn’s disease.It is necessary to take the examination of SBE even had a negative result.4. The method of SBE and CE are safety for most patients, but CE is even ea sier.