Capsule endoscopy sensitively detects the bleeding source in the small bowel.
However, the influence of capsule endoscopy on long-term outcome is not well established.
Dr Jorg Albert and colleagues identified all capsule endoscopy investigations dating back to 3 years in 5 tertiary hospitals.
Patients with intestinal bleeding and negative bidirectional endoscopy were included, and relapse of bleeding was recorded.
The researchers detected a bleeding source in 77% of patients.
|Capsule endoscopy provided the diagnosis in 80%|
|European Journal of Gastroenterology & Hepatology|
The team noted that capsule endoscopy provided the diagnosis in 80% and other, repeated investigations in 20%.
Follow-up in 240 patients, identified rebleeding in 27% of patients, and readmission to a hospital in 18% of patients.
Hospital readmission was most frequent in patients with angiectasias.
Other risk factors included patients being older than 60 years of age, and anticoagulant medication.
The team found that therapeutic measures had a mean recurrence rate of 4% in surgical candidates, 40% in endoscopically treated and 16% in medically treated patients.
In cases where all the detected angiectasias had been cauterized, the relapse rate was low in 12%, but in incompletely treated patients, it was 86%.
Bleeding relapse was never lethal.
Dr Albert‘s team concluded, “Capsule endoscopy guides therapeutic measures and predicts the risk of recurrent bleeding in small intestinal bleeding.”
“High risk of rebleeding in angiectasias is significantly reduced by the cauterization of all demonstrable lesions.”