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Gastrointest Endosc. 2007 Dec;66(6):1174-81.

Evaluation of capsule endoscopy in active, mild-to-moderate, overt, obscure GI bleeding.

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1
Department of Gastroenterology, Army Share Fund (NIMTS) Hospital, Athens, Greece.

Abstract

BACKGROUND:

The role of capsule endoscopy (CE) in the diagnosis of active mild-to-moderate GI bleeding (GIB) immediately after a negative EGD and ileocolonoscopy has not been prospectively evaluated.

OBJECTIVE:

To estimate the diagnostic yield and clinical significance of CE in patients with acute, obscure, overt, mild-to-moderate GIB.

DESIGN:

A single-center prospective study.

PATIENTS:

During a 3-year period, 573 patients admitted to the hospital with acute mild-to-moderate GIB were included in this study. Among them, 37 patients (6.5%) with negative endoscopic findings, after urgent upper- and lower-GI endoscopies, underwent CE within the first 48 hours to identify the source of bleeding.

RESULTS:

CE revealed active bleeding in 34 patients and a diagnostic yield of 91.9%, including angiodysplasias in 18 patients, ulcers in 3 patients, and tumors in 2 patients. In the remaining 11 patients (32%), CE revealed the site of bleeding: distal duodenum in 1 case (9%), jejunum in 6 cases (54%), ileum in 2 cases (18%), and cecum in 2 cases (18%). From the 37 bleeders, 16 were managed conservatively, 14 endoscopically, and 7 surgically. During a 12-month follow-up period, bleeding recurrence was observed in 5 of 32 (15.6%).

LIMITATIONS:

This study had a limited number of patients.

CONCLUSIONS:

CE appeared to have a high diagnostic yield in patients with acute, mild-to-moderate, active hemorrhage of obscure origin when performed in the hospital after a negative standard endoscopic evaluation and has important clinical value in guiding medical management.

PMID:
18061718
DOI:
10.1016/j.gie.2007.06.058
[Indexed for MEDLINE]

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