Diagnostic and therapeutic yields of balloon-assisted enteroscopy on different subtypes of patients with suspected small bowel bleeding

Abstract Background Small bowel bleeding accounts for about 5%-8% of all cases of gastrointestinal bleeding. Suspected small bowel bleeding (SSBB) can be classified into occult, inactive overt, and overt. Most patients with SSBB will undergo balloon-assisted enteroscopy (BAE) for diagnosis and treatment. There are currently no recommendations from practice guidelines on what is the best approach and limited information about diagnostic and therapeutic yields for each subtype of SSBB. Aims and Methods We aimed to investigate the diagnostic and therapeutic yields of BAE in the 3 subtypes of patients with SSBB by performing a retrospective analysis of all patients that underwent BAE for this diagnosis at the University of Alberta Hospital in a 5-year period. We also aimed to identify other factors that could influence diagnostic and therapeutic yields. Results The overall diagnostic and therapeutic yields of BAE for SSBB were 66% and 51%, respectively. When stratified by subtypes of SSBB, the diagnostic yield for occult, inactive overt, and active overt SSBB were reported to be 61%, 67%, and 95% (P < .05), respectively. BAE performed within 72 hours of presentation and patients requiring transfusion within the past 12 months had a significantly higher diagnostic yield. Conclusions Our data showed the clinical differences between the 3 subtypes of patients with SSBB and the usefulness of an appropriate and timely approach to maximize the diagnostic and therapeutic yields.