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Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy.
Endoscopy. 2003 Jul; 35(7):576-84.E

Abstract

BACKGROUND AND STUDY AIMS

This study was designed to prospectively compare the diagnostic yield of the M2A endoscopic capsule with that of video push-enteroscopy in exploring the small intestine in patients with obscure digestive bleeding.

PATIENTS AND METHODS

Patients with either occult or overt obscure digestive bleeding and a negative endoscopic work-up underwent a double intestinal investigation, with video push-enteroscopy and a wireless capsule, performed blindly by separate examiners. The diagnostic yield for each technique was defined as the frequency of detection of clinically relevant intestinal lesions, i. e. those having the potential for bleeding.

RESULTS

60 patients (27 men, 33 women; age 58 +/- 18 years; hemoglobin 9.4 +/- 2.5 g/dl) were included, 32 with occult and 28 with overt bleeding. Results were analyzed for 58 patients, who completed both examinations. Lesions were detected in 43 patients: with both techniques in 19, only by capsule in 21, and, conversely, only by push-enteroscopy in 3 (P = 0.04). Final diagnoses were as follows: a P2 lesion with high bleeding potential in 28 patients (19 angiomata, 6 ulcerations, 2 tumors, 1 case of intestinal varices); a P1 lesion with intermediate bleeding potential in 15 patients (2 patients with mucosal erosions, 13 patients with mucosal red spots); and there were normal findings from 15 procedures. No procedure induced any complication.

CONCLUSION

The use of the wireless endoscopy capsule detects significantly more clinically relevant intestinal lesions than video push-enteroscopy in patients with obscure digestive bleeding, raising the diagnostic yield to 67.2 %. Its influence on the clinical outcome for patients needs further investigation.

Authors+Show Affiliations

Gastroenterology Department, Hôpital Edouard Herriot, Lyon, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

12822092

Citation

Saurin, J-C, et al. "Diagnostic Value of Endoscopic Capsule in Patients With Obscure Digestive Bleeding: Blinded Comparison With Video Push-enteroscopy." Endoscopy, vol. 35, no. 7, 2003, pp. 576-84.
Saurin JC, Delvaux M, Gaudin JL, et al. Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy. Endoscopy. 2003;35(7):576-84.
Saurin, J. C., Delvaux, M., Gaudin, J. L., Fassler, I., Villarejo, J., Vahedi, K., Bitoun, A., Canard, J. M., Souquet, J. C., Ponchon, T., Florent, C., & Gay, G. (2003). Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy. Endoscopy, 35(7), 576-84.
Saurin JC, et al. Diagnostic Value of Endoscopic Capsule in Patients With Obscure Digestive Bleeding: Blinded Comparison With Video Push-enteroscopy. Endoscopy. 2003;35(7):576-84. PubMed PMID: 12822092.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy. AU - Saurin,J-C, AU - Delvaux,M, AU - Gaudin,J-L, AU - Fassler,I, AU - Villarejo,J, AU - Vahedi,K, AU - Bitoun,A, AU - Canard,J-M, AU - Souquet,J C, AU - Ponchon,T, AU - Florent,C, AU - Gay,G, PY - 2003/6/25/pubmed PY - 2003/12/3/medline PY - 2003/6/25/entrez SP - 576 EP - 84 JF - Endoscopy JO - Endoscopy VL - 35 IS - 7 N2 - BACKGROUND AND STUDY AIMS: This study was designed to prospectively compare the diagnostic yield of the M2A endoscopic capsule with that of video push-enteroscopy in exploring the small intestine in patients with obscure digestive bleeding. PATIENTS AND METHODS: Patients with either occult or overt obscure digestive bleeding and a negative endoscopic work-up underwent a double intestinal investigation, with video push-enteroscopy and a wireless capsule, performed blindly by separate examiners. The diagnostic yield for each technique was defined as the frequency of detection of clinically relevant intestinal lesions, i. e. those having the potential for bleeding. RESULTS: 60 patients (27 men, 33 women; age 58 +/- 18 years; hemoglobin 9.4 +/- 2.5 g/dl) were included, 32 with occult and 28 with overt bleeding. Results were analyzed for 58 patients, who completed both examinations. Lesions were detected in 43 patients: with both techniques in 19, only by capsule in 21, and, conversely, only by push-enteroscopy in 3 (P = 0.04). Final diagnoses were as follows: a P2 lesion with high bleeding potential in 28 patients (19 angiomata, 6 ulcerations, 2 tumors, 1 case of intestinal varices); a P1 lesion with intermediate bleeding potential in 15 patients (2 patients with mucosal erosions, 13 patients with mucosal red spots); and there were normal findings from 15 procedures. No procedure induced any complication. CONCLUSION: The use of the wireless endoscopy capsule detects significantly more clinically relevant intestinal lesions than video push-enteroscopy in patients with obscure digestive bleeding, raising the diagnostic yield to 67.2 %. Its influence on the clinical outcome for patients needs further investigation. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/12822092/Diagnostic_value_of_endoscopic_capsule_in_patients_with_obscure_digestive_bleeding:_blinded_comparison_with_video_push_enteroscopy_ L2 - https://www.thieme-connect.com/DOI/DOI?10.1055/s-2003-40244 DB - PRIME DP - Unbound Medicine ER -