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A prospective study comparing video capsule endoscopy with double-balloon enteroscopy in patients with obscure gastrointestinal bleeding.
Am J Gastroenterol. 2006 Jan; 101(1):52-7.AJ

Abstract

OBJECTIVE

Obscure gastrointestinal bleeding from jejunal and ileal lesions remains undiagnosed using traditional imaging techniques (radiologic, endoscopic). This prospective study compares the diagnostic detection rate of small-bowel lesions using wireless video capsule endoscopy (VCE) with the detection rate using double-balloon enteroscopy (DBE) in patients with obscure gastrointestinal bleeding (OGIB). Tolerance, adverse events, endoscopic interventions, and prognosis were described as secondary aims.

METHODS

Thirty-five consecutive patients with obscure gastrointestinal bleeding were evaluated (22 males and 13 females; mean age 63.2 yr; range, 19-86 yr). The detection rates of the Given M2A wireless VCE and DBE were compared.

RESULTS

Small-bowel abnormalities were detected using VCE in 28 (80%) of the 35 patients with OGIB, compared with 21 (60%) of the 35 patients using DBE (p = 0.01). Both examinations were well tolerated, but VCE was more acceptable to patients. No major adverse event occurred after either examination. Biopsies (n = 27), argon plasma coagulation (n = 19), tattoo injection (n = 8), and polypectomy (n = 2) were feasible with DBE when indicated in 27 of the 35 patients (77%). During a median (range) follow-up period of 5 (2-12) months, 26 (74%) patients remained clinically stable and did not require blood transfusions after DBE procedures. Eighteen (51%) of those who remained clinically stable had received APC therapy.

CONCLUSIONS

High detection rates of the causes of OGIB are feasible with VCE and DBE. Although the detection rate of VCE was superior, our results indicate that the procedures are complementary; an initial diagnostic imaging employing VCE might be followed by therapeutic and interventional DBE.

Authors+Show Affiliations

Small Bowel Diseases Unit, Department of Gastroenterology, VU University Medical Center, Amsterdam, the Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16405533

Citation

Hadithi, Muhammed, et al. "A Prospective Study Comparing Video Capsule Endoscopy With Double-balloon Enteroscopy in Patients With Obscure Gastrointestinal Bleeding." The American Journal of Gastroenterology, vol. 101, no. 1, 2006, pp. 52-7.
Hadithi M, Heine GD, Jacobs MA, et al. A prospective study comparing video capsule endoscopy with double-balloon enteroscopy in patients with obscure gastrointestinal bleeding. Am J Gastroenterol. 2006;101(1):52-7.
Hadithi, M., Heine, G. D., Jacobs, M. A., van Bodegraven, A. A., V Bodegraven, A. A., & Mulder, C. J. (2006). A prospective study comparing video capsule endoscopy with double-balloon enteroscopy in patients with obscure gastrointestinal bleeding. The American Journal of Gastroenterology, 101(1), 52-7.
Hadithi M, et al. A Prospective Study Comparing Video Capsule Endoscopy With Double-balloon Enteroscopy in Patients With Obscure Gastrointestinal Bleeding. Am J Gastroenterol. 2006;101(1):52-7. PubMed PMID: 16405533.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study comparing video capsule endoscopy with double-balloon enteroscopy in patients with obscure gastrointestinal bleeding. AU - Hadithi,Muhammed, AU - Heine,G Dimitri N, AU - Jacobs,Maarten A J M, AU - van Bodegraven,Adriaan A, AU - V Bodegraven,Adriaan A, AU - Mulder,Chris J J, PY - 2006/1/13/pubmed PY - 2006/3/8/medline PY - 2006/1/13/entrez SP - 52 EP - 7 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 101 IS - 1 N2 - OBJECTIVE: Obscure gastrointestinal bleeding from jejunal and ileal lesions remains undiagnosed using traditional imaging techniques (radiologic, endoscopic). This prospective study compares the diagnostic detection rate of small-bowel lesions using wireless video capsule endoscopy (VCE) with the detection rate using double-balloon enteroscopy (DBE) in patients with obscure gastrointestinal bleeding (OGIB). Tolerance, adverse events, endoscopic interventions, and prognosis were described as secondary aims. METHODS: Thirty-five consecutive patients with obscure gastrointestinal bleeding were evaluated (22 males and 13 females; mean age 63.2 yr; range, 19-86 yr). The detection rates of the Given M2A wireless VCE and DBE were compared. RESULTS: Small-bowel abnormalities were detected using VCE in 28 (80%) of the 35 patients with OGIB, compared with 21 (60%) of the 35 patients using DBE (p = 0.01). Both examinations were well tolerated, but VCE was more acceptable to patients. No major adverse event occurred after either examination. Biopsies (n = 27), argon plasma coagulation (n = 19), tattoo injection (n = 8), and polypectomy (n = 2) were feasible with DBE when indicated in 27 of the 35 patients (77%). During a median (range) follow-up period of 5 (2-12) months, 26 (74%) patients remained clinically stable and did not require blood transfusions after DBE procedures. Eighteen (51%) of those who remained clinically stable had received APC therapy. CONCLUSIONS: High detection rates of the causes of OGIB are feasible with VCE and DBE. Although the detection rate of VCE was superior, our results indicate that the procedures are complementary; an initial diagnostic imaging employing VCE might be followed by therapeutic and interventional DBE. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/16405533/A_prospective_study_comparing_video_capsule_endoscopy_with_double_balloon_enteroscopy_in_patients_with_obscure_gastrointestinal_bleeding_ L2 - https://doi.org/10.1111/j.1572-0241.2005.00346.x DB - PRIME DP - Unbound Medicine ER -