Long-Term Outcomes and Rebleeding Risk Factors in Suspected Small Bowel Bleeding: A Study Based on the Modified...

Area of Science:

• Gastroenterology
• Endoscopy
• Small Bowel Imaging

Background:

• Small-bowel endoscopy is crucial for diagnosing and managing suspected small bowel bleeding (SSBB).
• Rebleeding after treatment for SSBB remains a significant clinical challenge.
• Existing rebleeding prediction models often lack endoscopic data and long-term outcome information.

Purpose of the Study:

• To evaluate risk factors for rebleeding in patients with SSBB.
• To assess long-term outcomes following endoscopic interventions.
• To utilize the modified Saurin classification (modified SC), compatible with balloon-assisted endoscopy (BAE), for risk stratification.

Main Methods:

• Retrospective analysis of 278 patients with obscure gastrointestinal bleeding (OGIB) undergoing capsule endoscopy (CE) or BAE.
• Lesion categorization using the modified SC (P0, P1, P2, or no findings).
• Classification of treatments into endoscopic or definitive (surgical/interventional radiology).

Main Results:

• Modified SC P1 lesions (OR 2.33), antiplatelet use (OR 3.02), and treatment interventions (OR 2.28) were independent predictors of rebleeding.
• The 3-year rebleeding rate was significantly higher for P1 lesions (27.2%) compared to P0 (9.5%) and P2 (13.8%).
• Rebleeding occurred more frequently after endoscopic treatment (39.9%) than definitive treatment (10.5%).

Conclusions:

• Modified SC P1 lesions are a significant predictor of rebleeding in SSBB patients.
• Early detection and intervention for P1 lesions may reduce rebleeding rates.
• Proactive management strategies and sustained follow-up are essential for optimizing SSBB patient outcomes.