Diagnostic yield and clinical impact of capsule endoscopy in obscure gastrointestinal bleeding during routine clinical practice: a single-center experience.
Title | Diagnostic yield and clinical impact of capsule endoscopy in obscure gastrointestinal bleeding during routine clinical practice: a single-center experience. |
Publication Type | Journal Article |
Year of Publication | 2011 |
Authors | Katsinelos, P., Chatzimavroudis G., Terzoudis S., Patsis I., Fasoulas K., Katsinelos T., Kokonis G., Zavos C., Vasiliadis T., & Kountouras J. |
Journal | Med Princ Pract |
Volume | 20 |
Issue | 1 |
Pagination | 60-5 |
Date Published | 2011 |
ISSN | 1423-0151 |
Keywords | Adolescent, Adult, Aged, Aged, 80 and over, Anti-Inflammatory Agents, Non-Steroidal, Capsule Endoscopes, Endoscopy, Female, Gastrointestinal Diseases, Gastrointestinal Hemorrhage, Greece, Humans, Male, Middle Aged, Treatment Outcome, Young Adult |
Abstract | OBJECTIVE: This study assessed the diagnostic yield of capsule endoscopy (CE) and its impact on patients with obscure gastrointestinal bleeding (OGIB).SUBJECTS AND METHODS: Between May 2007 and May 2009, 63 patients with OGIB (overt bleeding: 25, and occult blood loss with chronic ferropenic anemia: 38) and normal upper and lower endoscopy were studied by CE. Demographic characteristics, prior diagnostic tests, CE findings, therapeutic interventions, medical treatment and clinical outcomes following CE were evaluated.RESULTS: The overall diagnostic yield was 44.44% of patients and included findings of angiectasia in 11 (17.46%) patients, nonsteroidal anti-inflammatory drugs enteropathy in 6 (9.52%) patients, celiac disease in 3 (4.76%) patients, tumors in 2 (3.17%) patients, and a variety of other diagnoses ranging from varices to ulcers (due to congenital afibrinogenemia and amyloidosis). The diagnostic yield was notably higher in overt bleeders (15/25, 60%) compared to occult bleeders (13/38, 34.21%; p = 0.044), and in patients with overt bleeding who had CE within the first 10 days (14/16, 87.5%) after the bleeding episode in comparison to overt bleeders who underwent CE >10 days after the bleeding episode (2/16, 11.1%; p < 0.0001). During follow-up (11.8 ± 7 months), CE findings led to specific therapy that resolved the underlying disease or improved the clinical condition in 45 of 63 patients, thus having a positive clinical impact of 71.43%.CONCLUSION: CE has a high diagnostic yield and a positive influence on clinical management in a significant proportion of patients with OGIB. These data further support the role of CE in routine clinical practice. |
DOI | 10.1159/000322071 |
Alternate Journal | Med Princ Pract |
PubMed ID | 21160216 |