CT enterography in obscure gastrointestinal bleeding: A systematic review and meta‐analysis

Summary The objective of this article is to provide a comprehensive and update overview of clinical application of CT enterography ( CTE ) in the evaluation of obscure gastrointestinal bleeding ( OGIB ). We performed a systematic review of relevant literatures in P ub M ed, EMBASE and The C ochrane L ibrary and pooled the yield of CTE and the incremental yield ( IY ) of CTE over an alternate modality. A total of 18 studies ( n  = 660) reported the yield of CTE in evaluating OGIB and the pooled yield was 40% (95% confidence interval ( CI ): 33–49%). Seven studies ( n  = 279) compared the yield of CTE with capsule endoscopy ( CE ). The yield for CTE and CE for all findings was 34% and 53%, respectively ( IY  = −19%, 95% CI  = −34% to −4%). When considering the types of identified lesions, the yield was significantly different for vascular and inflammatory lesions but not significantly different for neoplastic or other lesions. Two studies ( n  = 63) compared the yield of CTE with double‐balloon enteroscopy ( DBE ). The yield for CTE and DBE was 38% and 78%, respectively ( IY  = −40%, 95% CI  = −55% to −25%). Three studies ( n  = 49) compared the yield of CTE with digital subtraction angiography. The yield for CTE and digital subtraction angiography was 64% and 60%, respectively ( IY  = 4%, 95% CI  = −40% to 47%). CTE is an excellent diagnostic tool in patients with OGIB . It may play a complementary role to CE and can be used as a triage tool prior to DBE in evaluating OGIB .