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 23 February 2018

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News

Wireless capsule endoscopy for gastrointestinal bleeding

Capsule endoscopy is superior to push enteroscopy for the diagnosis of recurrent bleeding in patients who have had a negative gastroscopy and colonoscopy, finds a team of physicians in the August issue of Gut.

News image

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Wireless capsule endoscopy allows painless imaging of the small intestine. However, its clinical use is not defined.

In this study, physicians from England compared the clinical efficacy and technical performance of capsule endoscopy with push enteroscopy.

The team assessed 50 patients with colonoscopy and gastroscopy negative gastrointestinal bleeding.

The researchers used a wireless capsule endoscope containing a CMOS colour video imager, transmitter, and batteries. This transmits approximately 50,000 images, which are received by 8 abdominal aerials. They are stored on a portable solid state recorder, which is carried on a belt.

In addition, push enteroscopy was performed using a 240 cm Olympus video enteroscope.
Patients preferred capsule endoscopy to push enteroscopy.
Gut

The team also included 14 healthy volunteers to give information on normal anatomical appearances and preparation.

The physicians identified a bleeding source in the small intestine of 68% of the patients. These included angiodysplasia (16), focal fresh bleeding (8), apthous ulceration (3), tumor (2), Meckelís diverticulum (2), ileal ulcer (1), jejunitis (1), and ulcer due to intussusception (1).

They made 1 additional intestinal diagnosis on enteroscopy.

Overall, the yield of push enteroscopy in evaluating obscure bleeding was 32%.

The team found that capsule endoscopy identified significantly more small intestinal bleeding sources than push enteroscopy.

Furthermore, patients preferred capsule endoscopy to push enteroscopy.

Dr Mylonaki's team concluded, "Capsule endoscopy was superior to push enteroscopy in the diagnosis of recurrent bleeding in patients who had a negative gastroscopy and colonoscopy".

"It was safe and well tolerated".

Gut 2003; 52: 1122-6
22 July 2003

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