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[Evaluation of diagnostic yield and clinical impact of capsule endoscopy in patients with obscure gastrointestinal bleeding].
Orv Hetil. 2006 Sep 24; 147(38):1827-33.OH

Abstract

BACKGROUND AND AIMS

The major indication of small bowel capsule endoscopy is the diagnostics of obscure gastrointestinal bleeding. The present retrospective study was aimed to analyze the diagnostic yield, positive and negative predictive values and clinical impact of capsule endoscopy in patients with obscure gastrointestinal bleeding.

PATIENTS AND METHODS

During a 36 month period at two workplaces 66 capsule endoscopy studies were performed in 62 patients with gastrointestinal bleeding who had undergone non-diagnostic upper endoscopy and colonoscopy. Capsule video recordings were evaluated by two investigators at both workplaces. Capsule endoscopy findings were divided into 3 groups according to the bleeding source: definitive bleeding source (48 patients), uncertain bleeding potential (5 patients), and negative finding (8 patient). Patients after capsule endoscopy were followed-up until a mean of 20 (1-41) months.

RESULTS

A definitive small bowel bleeding source was detected in 78.7% of the cases studied by capsule endoscopy. Definitive bleeding sources included angiodysplasia (28 cases), small bowel Crohn's disease (5 cases), small bowel tumor (5 cases), small bowel stenosis (2 cases), NSAID therapy related ulcer (1 case), non-specific inflammation (1 case) and helminthiasis (1 case) respectively. The positive and negative predictive values of capsule endoscopy studies were 95.8% and 84.6% respectively. In cases with definitive bleeding sources 72% of patients received therapy in accordance with capsule endoscopy findings (surgery in 18 patients, medical treatment modification in 16 patients, chemoembolisation in 1 patient). During the follow-up period 17.7% of the patients had rebleeding.

CONCLUSIONS

Capsule endoscopy is a useful and effective diagnostic method in cases with obscure gastrointestinal bleeding. Effective therapy may be introduced in accordance with the majority of positive capsule endoscopy results.

Authors+Show Affiliations

Vaszary Kolos Kórház, II. Belgyógyászati Osztály, Esztergom. drmarta.kovacs@axelero.huNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

hun

PubMed ID

17066599

Citation

Kovács, Márta, et al. "[Evaluation of Diagnostic Yield and Clinical Impact of Capsule Endoscopy in Patients With Obscure Gastrointestinal Bleeding]." Orvosi Hetilap, vol. 147, no. 38, 2006, pp. 1827-33.
Kovács M, Németh A, Pák P, et al. [Evaluation of diagnostic yield and clinical impact of capsule endoscopy in patients with obscure gastrointestinal bleeding]. Orv Hetil. 2006;147(38):1827-33.
Kovács, M., Németh, A., Pák, P., Uhlyarik, A., Pák, G., & Rácz, I. (2006). [Evaluation of diagnostic yield and clinical impact of capsule endoscopy in patients with obscure gastrointestinal bleeding]. Orvosi Hetilap, 147(38), 1827-33.
Kovács M, et al. [Evaluation of Diagnostic Yield and Clinical Impact of Capsule Endoscopy in Patients With Obscure Gastrointestinal Bleeding]. Orv Hetil. 2006 Sep 24;147(38):1827-33. PubMed PMID: 17066599.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Evaluation of diagnostic yield and clinical impact of capsule endoscopy in patients with obscure gastrointestinal bleeding]. AU - Kovács,Márta, AU - Németh,Artur, AU - Pák,Péter, AU - Uhlyarik,Andrea, AU - Pák,Gábor, AU - Rácz,István, PY - 2006/10/28/pubmed PY - 2006/12/9/medline PY - 2006/10/28/entrez SP - 1827 EP - 33 JF - Orvosi hetilap JO - Orv Hetil VL - 147 IS - 38 N2 - BACKGROUND AND AIMS: The major indication of small bowel capsule endoscopy is the diagnostics of obscure gastrointestinal bleeding. The present retrospective study was aimed to analyze the diagnostic yield, positive and negative predictive values and clinical impact of capsule endoscopy in patients with obscure gastrointestinal bleeding. PATIENTS AND METHODS: During a 36 month period at two workplaces 66 capsule endoscopy studies were performed in 62 patients with gastrointestinal bleeding who had undergone non-diagnostic upper endoscopy and colonoscopy. Capsule video recordings were evaluated by two investigators at both workplaces. Capsule endoscopy findings were divided into 3 groups according to the bleeding source: definitive bleeding source (48 patients), uncertain bleeding potential (5 patients), and negative finding (8 patient). Patients after capsule endoscopy were followed-up until a mean of 20 (1-41) months. RESULTS: A definitive small bowel bleeding source was detected in 78.7% of the cases studied by capsule endoscopy. Definitive bleeding sources included angiodysplasia (28 cases), small bowel Crohn's disease (5 cases), small bowel tumor (5 cases), small bowel stenosis (2 cases), NSAID therapy related ulcer (1 case), non-specific inflammation (1 case) and helminthiasis (1 case) respectively. The positive and negative predictive values of capsule endoscopy studies were 95.8% and 84.6% respectively. In cases with definitive bleeding sources 72% of patients received therapy in accordance with capsule endoscopy findings (surgery in 18 patients, medical treatment modification in 16 patients, chemoembolisation in 1 patient). During the follow-up period 17.7% of the patients had rebleeding. CONCLUSIONS: Capsule endoscopy is a useful and effective diagnostic method in cases with obscure gastrointestinal bleeding. Effective therapy may be introduced in accordance with the majority of positive capsule endoscopy results. SN - 0030-6002 UR - https://www.unboundmedicine.com/medline/citation/17066599/[Evaluation_of_diagnostic_yield_and_clinical_impact_of_capsule_endoscopy_in_patients_with_obscure_gastrointestinal_bleeding]_ L2 - https://medlineplus.gov/gastrointestinalbleeding.html DB - PRIME DP - Unbound Medicine ER -