Evaluation of double-balloon enteroscopy in the management of type 1 small bowel vascular lesions (angioectasia): a retrospective cohort study

Abstract Background Small-bowel angioectasia is commonly diagnosed and managed using double-balloon enteroscopy; however, rebleeding rates can vary significantly. This study aimed to identify and evaluate the clinical predictors of rebleeding in patients with small-bowel angioectasia. Methods This r...

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Main Authors: Suleyman Dolu, Mehmet Emin Arayici, Soner Onem, Ilker Buyuktorun, Huseyin Dongelli, Goksel Bengi, Mesut Akarsu
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-03591-x
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author Suleyman Dolu
Mehmet Emin Arayici
Soner Onem
Ilker Buyuktorun
Huseyin Dongelli
Goksel Bengi
Mesut Akarsu
author_facet Suleyman Dolu
Mehmet Emin Arayici
Soner Onem
Ilker Buyuktorun
Huseyin Dongelli
Goksel Bengi
Mesut Akarsu
author_sort Suleyman Dolu
collection DOAJ
description Abstract Background Small-bowel angioectasia is commonly diagnosed and managed using double-balloon enteroscopy; however, rebleeding rates can vary significantly. This study aimed to identify and evaluate the clinical predictors of rebleeding in patients with small-bowel angioectasia. Methods This retrospective study focused on adult patients who underwent endoscopic management for small bowel vascular lesions (SBVLs). A total of 67 patients were included in the study, all of whom were retrospectively analyzed. The SBVLs were classified using the Yano et al. classification system. Among these, 62 patients with angioectasia who received endoscopic treatment were specifically analyzed. To further investigate the clinical outcomes, the angioectasia group that required endoscopic treatment was divided into two subgroups based on the number of double-balloon enteroscopy (DBE) procedures performed. Univariate and multivariate binary logistic regression analyses were used to establish which predictor variables were significantly related to the recurrence. Results A total of 67 patients (mean age 68.1 ± 8.9 years; 44 males) with SBVL, angioectasia was diagnosed in 62 (92.5%) patients, dieulafoy lesion in 1 (1.5%) patient, and arteriovenous malformation in 4 (6%) patients. Similarly, the prevalence of chronic renal failure and diabetes mellitus were significantly higher in the multiple DBE endotherapy group compared to the single DBE endotherapy group (p < 0.001; p = 0.032, respectively). In multivariate logistic regression analysis, anticoagulant use (OR = 9.648, 95% CI: 1.729–53.817, p = 0.010), chronic renal failure (OR = 15.683, 95% CI: 2.727–90.203, p = 0.002), localization of duodenum (OR = 13.509, 95% CI: 1.598–114.168, p = 0.017), and localization of the ileum (OR = 17.100, 95% CI: 1.477–197.905, p = 0.023) were all independently associated with a higher risk of angioectasia recurrence. Conclusions The findings of this study demonstrates a high success rate of endoscopic treatment, with a rebleeding rate of 27%, highlighting the significance of this approach. Chronic renal failure, use of anticoagulant, and lesion localization in the duodenum or ileum were identified as independent risk factors for rebleeding, underscoring the need for careful patient monitoring and targeted intervention in these cases.
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spelling doaj-art-ebe2d99f56754aaab15d77503fef6c032025-01-19T12:25:44ZengBMCBMC Gastroenterology1471-230X2025-01-0125111010.1186/s12876-025-03591-xEvaluation of double-balloon enteroscopy in the management of type 1 small bowel vascular lesions (angioectasia): a retrospective cohort studySuleyman Dolu0Mehmet Emin Arayici1Soner Onem2Ilker Buyuktorun3Huseyin Dongelli4Goksel Bengi5Mesut Akarsu6Department of Gastroenterology, Faculty of Medicine, Dokuz Eylul UniversityDepartment of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eylül UniversityDepartment of Gastroenterology, Gazi State HospitalDepartment of Gastroenterology, Faculty of Medicine, Dokuz Eylul UniversityDepartment of Internal Medicine, Faculty of Medicine, Dokuz Eylul UniversityDepartment of Gastroenterology, Faculty of Medicine, Dokuz Eylul UniversityIndependent ResearcherAbstract Background Small-bowel angioectasia is commonly diagnosed and managed using double-balloon enteroscopy; however, rebleeding rates can vary significantly. This study aimed to identify and evaluate the clinical predictors of rebleeding in patients with small-bowel angioectasia. Methods This retrospective study focused on adult patients who underwent endoscopic management for small bowel vascular lesions (SBVLs). A total of 67 patients were included in the study, all of whom were retrospectively analyzed. The SBVLs were classified using the Yano et al. classification system. Among these, 62 patients with angioectasia who received endoscopic treatment were specifically analyzed. To further investigate the clinical outcomes, the angioectasia group that required endoscopic treatment was divided into two subgroups based on the number of double-balloon enteroscopy (DBE) procedures performed. Univariate and multivariate binary logistic regression analyses were used to establish which predictor variables were significantly related to the recurrence. Results A total of 67 patients (mean age 68.1 ± 8.9 years; 44 males) with SBVL, angioectasia was diagnosed in 62 (92.5%) patients, dieulafoy lesion in 1 (1.5%) patient, and arteriovenous malformation in 4 (6%) patients. Similarly, the prevalence of chronic renal failure and diabetes mellitus were significantly higher in the multiple DBE endotherapy group compared to the single DBE endotherapy group (p < 0.001; p = 0.032, respectively). In multivariate logistic regression analysis, anticoagulant use (OR = 9.648, 95% CI: 1.729–53.817, p = 0.010), chronic renal failure (OR = 15.683, 95% CI: 2.727–90.203, p = 0.002), localization of duodenum (OR = 13.509, 95% CI: 1.598–114.168, p = 0.017), and localization of the ileum (OR = 17.100, 95% CI: 1.477–197.905, p = 0.023) were all independently associated with a higher risk of angioectasia recurrence. Conclusions The findings of this study demonstrates a high success rate of endoscopic treatment, with a rebleeding rate of 27%, highlighting the significance of this approach. Chronic renal failure, use of anticoagulant, and lesion localization in the duodenum or ileum were identified as independent risk factors for rebleeding, underscoring the need for careful patient monitoring and targeted intervention in these cases.https://doi.org/10.1186/s12876-025-03591-xDouble-balloon enteroscopySmall bowel vascular lesionAngioectasia
spellingShingle Suleyman Dolu
Mehmet Emin Arayici
Soner Onem
Ilker Buyuktorun
Huseyin Dongelli
Goksel Bengi
Mesut Akarsu
Evaluation of double-balloon enteroscopy in the management of type 1 small bowel vascular lesions (angioectasia): a retrospective cohort study
BMC Gastroenterology
Double-balloon enteroscopy
Small bowel vascular lesion
Angioectasia
title Evaluation of double-balloon enteroscopy in the management of type 1 small bowel vascular lesions (angioectasia): a retrospective cohort study
title_full Evaluation of double-balloon enteroscopy in the management of type 1 small bowel vascular lesions (angioectasia): a retrospective cohort study
title_fullStr Evaluation of double-balloon enteroscopy in the management of type 1 small bowel vascular lesions (angioectasia): a retrospective cohort study
title_full_unstemmed Evaluation of double-balloon enteroscopy in the management of type 1 small bowel vascular lesions (angioectasia): a retrospective cohort study
title_short Evaluation of double-balloon enteroscopy in the management of type 1 small bowel vascular lesions (angioectasia): a retrospective cohort study
title_sort evaluation of double balloon enteroscopy in the management of type 1 small bowel vascular lesions angioectasia a retrospective cohort study
topic Double-balloon enteroscopy
Small bowel vascular lesion
Angioectasia
url https://doi.org/10.1186/s12876-025-03591-x
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