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Factors associated with diagnosis of obscure GI bleeding by video capsule enteroscopy

The latest issue of the Clinical Gastroenterology & Hepatology identifies factors associated with diagnosis of obscure gastrointestinal bleeding by video capsule enteroscopy.

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Capsule enteroscopy is the best noninvasive tool to explore the entire small bowel of patients with obscure gastrointestinal bleeding; it has a diagnostic yield of 40%–80%. 

However, little is known about the factors associated with a diagnosis of obscure gastrointestinal bleeding by capsule enteroscopy.

Dr Lucie Lepileur from France analyzed data from 911 consecutive patients who underwent Capsule enteroscopy for obscure gastrointestinal bleeding from 2004 to 2010. 
 
Results from upper and lower gastrointestinal endoscopy examinations were negative in all patients. 

Capsule enteroscopy findings were recorded. 
Women were less likely to be diagnosed with obscure GI bleeding
Clinical Gastroenterology & Hepatology
The team found that the features of patients that were associated with diagnosis of obscure gastrointestinal bleeding by capsule enteroscopy were identified by using logistic regression.

Based on Capsule enteroscopy, 509 patients had a confirmed lesion responsible for the obscure gastrointestinal bleeding.
 
The team found that 203 had disease of the small bowel, 88 had ulceration, 70 had tumors, 24 had varices, 6 had diverticula, and 118 had what appeared to be bleeding lesions of the esophagus or stomach or colon. 

The doctors reported that the factors were independently associated with a diagnosis of obscure gastrointestinal bleeding by capsule enteroscopy were age 60 years, male sex, history of overt bleeding, and current hospitalization.

Women were less likely to be diagnosed with obscure gastrointestinal bleeding by capsule enteroscopy.
 
Dr Lepileur concludes that "A history of overt bleeding is the factor most strongly associated with a diagnosis of obscure gastrointestinal bleeding by capsule enteroscopy." 
 
"Male sex, age 60 years, and inpatient status were also independent predictors of positive diagnosis by capsule enteroscopy."

Clin Gastroenterol Hepatol 2012: 10 (12 ): 1376-1380

07 December 2012

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