Capsule endoscopy has revolutionized the evaluation of obscure gastrointestinal (GI) bleeding.
However, published literature is limited to small series with heterogeneous indications.
Dr Elizabeth Carey and colleagues from Arizona determined the diagnostic yield of capsule endoscopy in 260 patients with overt and occult obscure gastrointestinal bleeding.
The investigators obtained data on 126 patients who underwent capsule endoscopy for overt or 134 had occult obscure gastrointestinal bleeding.
The team received the data by retrospective chart review and review of an internal database of capsule endoscopy patients and findings.
|Clinically significant positive findings occurred in 53%|
|American Journal of Gastroenterology|
Visualization of the entire small bowel was achieved in 74%.
The investigative team found that 66% of exams were rated as having a good or excellent preparation.
Clinically significant positive findings occurred in 53%.
The yield of capsule endoscopy in the obscure-overt group was greater than in the obscure-occult group.
The team observed that small bowel angioectasias were the most common finding, comprising over 60% of lesions.
The mean follow-up was 10 months.
The investigators found significant reductions in hospitalizations, additional tests/procedures, and units of blood transfused after capsule endoscopy.
Both before and after capsule endoscopy, patients in the overt group had more significant GI bleeding than patients in the occult group.
The investigative team noted that complications occurred in 2% of cases.
The complications included nonnatural excretion and capsule endoscopy impaction at cricopharyngeus.
Dr Carey's team commented, “The yield of clinically important findings on capsule endoscopy in patients with obscure gastrointestinal bleeding is 53%.”
“It is greater in patients with obscure-overt than obscure-occult GI bleeding.”
“Angioectasias account for the majority of significant lesions in both groups.”
“Compared with pre-capsule endoscopy, patients had clinical improvement post-capsule endoscopy in medical interventions for obscure gastrointestinal bleeding.”
“Complications of capsule endoscopy occur in less than 2% of cases.”