Enteroscopy improves the clinical outcome in patients with obscure gastrointestinal bleeding

Push enteroscopy is often performed to identify and treat the source of blood loss in patients with obscure gastrointestinal blood loss. This study was designed to determine whether enteroscopy alters the clinical outcome in these patients. This was a retrospective study of 50 patients who underwent push enteroscopy for obscure GI blood loss. Information was obtained from chart review and telephone contact with both patients and physicians. Data collected included patient demographics, days hospitalized, and packed red blood cell transfusions for 6 months pre- and postprocedure, diagnostic yield, return to premorbid function, and a global patient's and referring physician's assessment of efficacy. For analysis, patients were subgrouped by whether or not enteroscopy identified a source for the bleeding. Complete data were available for 41 of 50 patients. Sixty-seven percent were female, with a mean age of 65+/-2.1 years. Positive findings were seen in 78%. In patients with a positive finding, there was a decrease in hospitalization days (from 17.4+/-4.5 to 7.2+/-3.0) and transfusions (from 7.9+/-1.3 to 3.0+/-1.1) in the 6 months following the procedure. Patients without findings had a significant decrease in transfusions (from 13.7+/-6.7 to 8.2+/-4.9), but not hospitalization. Forty-four percent of patients returned to premorbid function. One-third of patients and half of their physicians felt that the procedure was beneficial. Push enteroscopy improves patient clinical outcome in obscure GI bleeding--especially when a diagnostic finding is obtained.