Risk of rebleeding in patients with small bowel vascular lesions

Akira Harada, Takehiro Torisu, Shin Fujioka, Yuichiro Yoshida, Yasuharu Okamoto, Yuta Fuyuno, Atsushi Hirano, Junji Umeno, Kumiko Torisu, Tomohiko Moriyama, Motohiro Esaki, Takanari Kitazono

Research output: Contribution to journalArticlepeer-review

Abstract

Objective With recent advances in endoscopic modalities, small bowel vascular lesions (SBVLs) are often now detected in patients with gastrointestinal bleeding. Given the high invasiveness of endoscopic treatment, it is important to select patients at high risk for bleeding. To assess the risk of rebleeding in patients with SBVLs as a systemic disease rather than a gastrointestinal disease in relation to their general health. Methods We retrospectively analyzed the clinical data of 55 patients with SBVLs among patients with obscure gastrointestinal bleeding. The possible association between the clinical findings and the updated Charlson comorbidity index with rebleeding was evaluated. Results Gastrointestinal rebleeding occurred in 20 patients (36.4%) during the follow-up period. The presence of multiple comorbidities as indicated by an updated Charlson comorbidity index of !4 was a risk factor for rebleeding (hazard ratio, 3.64; p=0.004). Other risk factors were arteriosclerosis of the superior mesenteric artery and multiple SBVLs. Endoscopic hemostasis and the discontinuation of antithrombotic medications were not significantly associated with rebleeding. Patients with a high updated Charlson comorbidity index had a high risk of death of causes other than gastrointestinal rebleeding. Conclusion Gastrointestinal rebleeding is not a rare condition among patients with SBVLs. Patients with poor general health may therefore have a higher risk of rebleeding.

Original languageEnglish
Pages (from-to)3663-3669
Number of pages7
JournalInternal Medicine
Volume60
Issue number23
DOIs
Publication statusPublished - 2021
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Fingerprint

Dive into the research topics of 'Risk of rebleeding in patients with small bowel vascular lesions'. Together they form a unique fingerprint.

Cite this