Capsule endoscopy has been shown to have a high diagnostic yield in patients with obscure gastrointestinal bleeding.
It is not known if repeating capsule endoscopy improves diagnostic yield or changes patient management when the initial capsule endoscopy is negative or nondiagnostic.
Dr Leighton and colleagues from Arizona conducted a study to understand the reasons for repeat capsule endoscopy.
The researchers also determined the diagnostic yield of repeat capsule endoscopy, and established if findings on repeat capsule endoscopy resulted in a change in patient management.
The investigators performed 391 capsule studies between 2001 and 2003.
|These findings led to changes in patient management in 63 % of cases|
|American Journal of Gastroenterology|
Of these, 24 were repeat studies in patients with obscure gastrointestinal bleeding and the research team retrospectively reviewed the charts of these 24 patients.
The reasons for repeat capsule endoscopy included recurrent gastrointestinal bleeding, limited visualization on first exam due to poor prep or blood and capsule impaction at cricopharyngeus.
The research team found that 75 % of repeat capsule studies revealed additional findings.
The researchers reported that these additional findings included 7 arteriovenous malformations, 2 gastropathies, 2 erosions, 2 masses, 1 ulcer, 2 red spots, 1 linear streak and 1 erythema.
These findings led to changes in patient management in 63 % of cases.
Dr Leighton’s team concludes, “Indications for repeat capsule endoscopy most commonly include recurrent gastrointestinal bleeding and limited visualization on initial study.”
“Repeat capsule endoscopy results in a high yield of new findings that lead to changes in patient management.”
“Repeat capsule endoscopy should be considered in patients with persistent obscure gastrointestinal bleeding when the initial study is negative or inconclusive.”