Abstract
Background/aims The rate of recurrent small-bowel bleeding (SBB) remains high despite the advent
of balloon assisted enteroscopy (BAE). The study aims were to determine: (1) the diagnostic
and therapeutic yields, and adverse event rate of repeat BAE in SBB, and (2) the predictors
of a positive repeat BAE.
Methods A retrospective review of a BAE database was conducted. Patients who had > 1 BAE
for SBB were included. Primary outcomes were diagnostic yield, therapeutic yield,
and adverse events of repeat BAE. Secondary outcomes were predictors of a positive
repeat BAE.
Results A total of 175 patients (55 % men; mean age 64.1 ± 16.3 years) were included. The
diagnostic and therapeutic yields of repeat BAE were 55 % and 42 %, respectively.
Repeat BAE adverse events occurred in 5 % with self-limited abdominal pain being most
common. Patients with a positive repeat BAE were significantly older than the negative
group (68.6 ± 13.9 vs. 60.9 ± 17.1; P = 0.001) and were more likely to have cardiac comorbidities (OR 2.4, 95 %CI: 1.3 – 4.6;
P = 0.01), chronic kidney disease (OR 2.3, 95 %CI: 1.1 – 4.9; P = 0.04), chronic obstructive pulmonary disease (OR 3.3, 95 %CI: 1.3 – 8.1; P = 0.01), positive initial BAE (OR 3.6, 95 %CI: 1.9 – 6.8; P < 0.001), and antegrade procedure (OR 3.3, 95 %CI: 1.7 – 6.1; P < 0.001). On multivariate analysis, a positive initial BAE and antegrade route were
the only significant predictive factors.
Conclusions Performing a repeat BAE for SBB appears safe and provided modest yields. A positive
initial BAE and antegrade route were predictive of a positive repeat BAE.
