Capsule endoscopy is superior to push enteroscopy and small bowel barium radiography in detecting the source of obscure gastrointestinal (GI) bleeding.
Dr Esteve Saperas and colleagues from Spain compared whether capsule endoscopy has a superior diagnostic yield than computed tomography angiography or standard mesenteric angiography.
The team assessed 28 patients who were admitted for obscure GI bleeding and underwent computed tomography and standard angiography between 2004 and 2005.
|Capsule endoscopy detected bleeding in 72% of patients|
|The American Journal of Gastroenterology|
The techniques were followed by capsule endoscopy, performed blindly by independent examiners within 7 days of admission.
The investigators' primary end point was the diagnostic yield for each technique.
The diagnostic yield was defined as the frequency of detection of lesions with a high probability of bleeding.
The team reported that computed tomography angiography or standard angiography could be performed in 25 of 28 patients.
The remaining 3 patients had contrast allergy or chronic renal failure.
The investigators detected a source of bleeding by capsule endoscopy in 72% of patients.
Using computed tomography angiography, the team detected a source of bleeding in 24% of patients.
The investigative team identified a source of bleeding in 56% of patients using standard angiography.
Similarly, capsule endoscopy was able to diagnose 100% of patients diagnosed by computed tomography angiography.
In addition, the team noted that capsule endoscopy identified 86% of patients initially diagnosed by standard angiography.
Capsule endoscopy was positive in 63% of negative cases on computed tomography angiography, and 55% of negative cases on standard angiography.
As a result of the capsule endoscopy findings, the team undertook therapeutic intervention in 47% of patients with positive results.
Dr Saperas' team commented, “Capsule endoscopy detects more lesions than computed tomography angiography or standard mesenteric angiography in patients with obscure GI bleeding.”
“It has a therapeutic impact in almost half of the patients with positive findings.”