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News

Diagnostic techniques for gastrointestinal bleeding

Capsule endoscopy has high sensitivity and specificity to detect a bleeding source, and the study in the latest Gastrointestinal Endoscopy recommends it for examination of obscure gastrointestinal bleeding.

News image

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Capsule endoscopy enables noninvasive diagnostic examination of the entire small intestine.

However, sensitivity and specificity of capsule endoscopy have not been adequately defined.

Capsule endoscopy showed the source of bleeding in 74% of patients
Gastrointestinal Endoscopy

Dr Riemann and colleagues from Germany compared capsule endoscopy.

The research team used intraoperative enteroscopy as a criterion standard inpatients with obscure gastrointestinal bleeding.

The team included 47 consecutive patients with obscure gastrointestinal bleeding from 2 German gastroenterologic centers.

Of the 47 included patients, 11 had ongoing overt bleeding, 24 had previous overt bleeding, and 12 had obscure-occult bleeding.

The researchers reported that all patients who had a prior nondiagnostic evaluation underwent capsule endoscopy followed by intraoperative enteroscopy.

Patients who had colonoscopy with a retrograde examination of the distal ileum, and push enteroscopy, also underwent capsule endoscopy followed by intraoperative enteroscopy.

The team found that capsule endoscopy identified lesions in 100% of the patients with ongoing overt bleeding.

The researchers also found that capsule endoscopy identified lesions in 67% of the patients with previous overt bleeding.

In addition, the team noted that capsule endoscopy identified lesions in 67% of the patients with obscure-occult bleeding.

Angiectasias were the most common source of bleeding in 22 of the patients.

The team reported that capsule endoscopy showed the source of bleeding in 74% of all patients.

The researchers observed that the method was more effective in patients with ongoing bleeding.

Compared with intraoperative enteroscopy sensitivity, and specificity were 95%, and 75%, respectively.

The research team also showed that positive and negative predictive values of capsule endoscopy 95% and 86%, respectively.

Dr Riemann's team concludes, “Capsule endoscopy has high sensitivity and specificity to detect a bleeding source in patients with obscure gastrointestinal bleeding.”

“Thus, wireless capsule endoscopy can be recommended as part of the routine work-up in patients with obscure gastrointestinal bleeding."

Gastrointest Endosc 2005: 61(7): 826
08 June 2005

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