Several studies have shown the value of capsule endoscopy and double balloon endoscopy in small-intestinal bleeding.
Dr Fujimori and colleagues from Japan evaluated the impact of capsule endoscopy results on subsequent double balloon endoscopy examination in patients with obscure gastrointestinal (GI) bleeding.
The researchers also assessed the 1-year clinical outcome of this combined approach.
|Re-bleeding occurred in 5% with positive diagnoses on capsule endoscopy|
The team assessed a total of 45 consecutive patients with obscure gastrointestinal bleeding who underwent capsule endoscopy.
Patients with positive capsule endoscopy results underwent double balloon endoscopy for biopsy or therapy.
Those with negative results underwent further assessment for possible diagnostic misses on capsule endoscopy.
The team considered tumors, ulcerations, and vascular lesions as sources of bleeding.
The researchers found responsible lesions in 49% of patients.
The team noted that 40% of patients underwent capsule endoscopy, and 50% undergwent subsequent double balloon endoscopy.
In all, the team found 10 tumors, 9 vascular lesions, and 4 ulcerations.
In 2 patients, vascular lesions were only later diagnosed by conventional methods.
Capsule endoscopy results guided the researchers' choice of the proper double balloon endoscopy model for successful therapeutic intervention in 5 patients.
The team found that re-bleeding rates were low during 1-year follow-up of the entire group.
Re-bleeding occurred in 5% of cases with positive diagnoses on capsule endoscopy and/or double balloon endoscopy, and 12% in negative cases.
Dr Fujimori's team concluded, "A combined approach using capsule endoscopy followed by double balloon endoscopy proves valuable in the diagnosis and treatment of patients with obscure gastrointestinal bleeding."
"It leaves a low rate of undiagnosed bleeding sources, and has a good long-term outcome."