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|
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."