Diagnostic yield and clinical outcomes after capsule endoscopy in 100 consecutive patients with obscure gastrointestinal bleeding

• Published in: European journal of gastroenterology & hepatology Vol. 18; no. 8; p. 881
• Main Authors: Estévez, Emilio, González-Conde, Benito, Vázquez-Iglesias, José Luis, de Los Angeles Vázquez-Millán, Maria, Pértega, Sonia, Alonso, Pedro A, Clofent, Joan, Santos, Eva, Ulla, José Luis, Sánchez, Eloy
• Format: Journal Article
• Language: English
• Published: England 01.08.2006
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Blood Transfusion; Capsule Endoscopy; Female; Follow-Up Studies; Gastrointestinal Hemorrhage - diagnosis; Gastrointestinal Hemorrhage - etiology; Gastrointestinal Hemorrhage - therapy; Humans; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; ROC Curve; Treatment Outcome
• ISSN: 0954-691X
• DOI: 10.1097/00042737-200608000-00014

The endoscopic capsule is a useful tool for visualizing the small bowel in patients with obscure gastrointestinal bleeding. In this study the authors evaluated the diagnostic aid provided by the endoscopic capsule, the factors predicting a significant finding and their impact on the patients' clinical evolution. A total of 100 patients (52 men and 48 women, average age 64.4 years) underwent capsule endoscopy. Of this group, 52 patients presented with obscure-overt bleeding and 48 with obscure-occult bleeding. After an average follow-up time of 11.4 months, the clinical outcome was evaluated in 95 patients. The endoscopic capsule identified significant findings in 68% of patients. The most common diagnosis (33.8%) was angiodysplasias. The most important factor predicting significant findings was the previous need for transfusion in the overt bleeding group. As the result of the findings, a specific intervention was made in 75.8% of patients. At the end of follow-up, the clinical outcome was considered positive in 71.6% of patients. Capsule retention occurred in one patient, who required surgery. In patients with obscure gastrointestinal bleeding, capsule endoscopy provides a high degree of diagnostic aid. The best candidates for this procedure are patients with obscure-overt bleeding who have required blood transfusions. Capsule endoscopy has a positive influence on an important proportion of patients, whether oriented towards new diagnostic techniques or towards a definitive treatment.