History of malignancy and relevant symptoms may predict a positive computed tomography enterography in obscure gastrointestinal bleeds. Issue 9 (6th June 2019)

• Record Type: Journal Article
• Authors: Leung, Kristel K; Khan, Usman; Zhang, Mei; McCurdy, Jeffrey D; James, Paul D
• Is Part Of: Journal of gastroenterology and hepatology. Volume 34:Issue 9(2019)
• Page Start: 1511
• Page End: 1516
• Publication Date: 2019-06-06
• Subjects: capsule endoscopy -- computed tomography enterography -- gastrointestinal bleeding; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.14682
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background and Aim: This study aimed to assess the clinical utility of computed tomography enterography (CTE) and identify factors associated with a diagnostic CTE for patients with obscure gastrointestinal bleeding (OGIB). Methods: A retrospective observational study was performed at a Canadian tertiary care center from 2005 to 2015. A total of 138 patients underwent a CTE for OGIB. Univariate and multivariate logistic regressions were performed to determine factors associated with a diagnostic CTE. A highly sensitive clinical rule was then developed to help identify OGIB patients for whom a CTE may be beneficial in their clinical work‐up. Results: A possible bleeding source was identified in 30 (22%) cases. The presence of abdominal or constitutional symptoms as well as history of colorectal cancer was significantly associated with a positive CTE in univariate and multivariate analyses ( P < 0.05). A positive CTE could be predicted based on the presence of abdominal or constitutional symptoms and history of colorectal cancer with 90% sensitivity (95% CI 74–98%) in our population. Conclusion: CTE identified a possible source of OGIB in one in five cases. In patients with the presence of abdominal or constitutional symptoms and a personal history of colorectal cancer, CTE may contribute to their diagnostic work‐up.