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Background <p>Small-bowel endoscopy is essential for diagnosing and managing suspected small bowel bleeding (SSBB); however, rebleeding after treatment remains clinically challenging. Although several rebleeding prediction models have been proposed, few are based on endoscopic findings, and data on long-term outcomes are limited.</p> Aims <p>This study aimed to evaluate rebleeding risk factors and long-term outcomes using the modified Saurin classification (modified SC), which is compatible with balloon-assisted endoscopy (BAE).</p> Methods <p>We retrospectively evaluated 278 consecutive patients with OGIB who underwent capsule endoscopy (CE) or BAE between October 2008 and December 2023. The lesions were categorized using modified SC as P0 (<i>n</i> = 58), P1 (<i>n</i> = 109), P2 (<i>n</i> = 71), or no findings (<i>n</i> = 40). Treatment was classified as endoscopic or definitive (surgical or interventional radiology).</p> Results <p>Of the 278 patients (mean age 67.7&#xa0;years; 150 males), 158 had occult OGIB and 120 had overt OGIB. Treatment was administered to 73 patients (46 endoscopic and 27 definitive cases). Over a mean follow-up of 2.2&#xa0;years, 32 patients (11.5%) experienced rebleeding. Multivariate analysis identified modified SC P1 lesions (odds ratios [ORs], 2.33; <i>p</i> = 0.03), antiplatelet drugs use (ORs 3.02, <i>p</i> = 0.04) and treatment interventions (ORs, 2.28; <i>p</i> = 0.02) as independent predictors. The 3-year rebleeding rate was higher in P1 (27.2%) than in P0 (9.5%) and P2 (13.8%). Rebleeding was more frequent in the endoscopic group (39.9%) than in the definitive group (10.5%; <i>p</i> = 0.04).</p> Conclusion <p>Modified SC P1 lesions were significantly associated with rebleeding. Proactive treatment strategies and long-term follow-up are crucial for effective management of SSBB.</p>

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Long-Term Outcomes and Rebleeding Risk Factors in Suspected Small Bowel Bleeding: A Study Based on the Modified Saurin Classification

  • 期刊论文

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  • 发表日期：

    2026年1月4日

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  • Sachiyo Onishi,
  • Kiichi Otani,
  • Naoya Masuda,
  • Hiroki Taniguchi,
  • Kentaro Kojima,
  • Jun Takada,
  • Masaya Kubota,
  • Takashi Ibuka,
  • Masahito Shimizu

摘要

Background

Small-bowel endoscopy is essential for diagnosing and managing suspected small bowel bleeding (SSBB); however, rebleeding after treatment remains clinically challenging. Although several rebleeding prediction models have been proposed, few are based on endoscopic findings, and data on long-term outcomes are limited.

Aims

This study aimed to evaluate rebleeding risk factors and long-term outcomes using the modified Saurin classification (modified SC), which is compatible with balloon-assisted endoscopy (BAE).

Methods

We retrospectively evaluated 278 consecutive patients with OGIB who underwent capsule endoscopy (CE) or BAE between October 2008 and December 2023. The lesions were categorized using modified SC as P0 (n = 58), P1 (n = 109), P2 (n = 71), or no findings (n = 40). Treatment was classified as endoscopic or definitive (surgical or interventional radiology).

Results

Of the 278 patients (mean age 67.7 years; 150 males), 158 had occult OGIB and 120 had overt OGIB. Treatment was administered to 73 patients (46 endoscopic and 27 definitive cases). Over a mean follow-up of 2.2 years, 32 patients (11.5%) experienced rebleeding. Multivariate analysis identified modified SC P1 lesions (odds ratios [ORs], 2.33; p = 0.03), antiplatelet drugs use (ORs 3.02, p = 0.04) and treatment interventions (ORs, 2.28; p = 0.02) as independent predictors. The 3-year rebleeding rate was higher in P1 (27.2%) than in P0 (9.5%) and P2 (13.8%). Rebleeding was more frequent in the endoscopic group (39.9%) than in the definitive group (10.5%; p = 0.04).

Conclusion

Modified SC P1 lesions were significantly associated with rebleeding. Proactive treatment strategies and long-term follow-up are crucial for effective management of SSBB.