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Evaluation of capsule endoscopy in active, mild-to-moderate, overt, obscure GI bleeding.
Gastrointest Endosc. 2007 Dec; 66(6):1174-81.GE

Abstract

BACKGROUND

The role of capsule endoscopy (CE) in the diagnosis of active mild-to-moderate GI bleeding (GIB) immediately after a negative EGD and ileocolonoscopy has not been prospectively evaluated.

OBJECTIVE

To estimate the diagnostic yield and clinical significance of CE in patients with acute, obscure, overt, mild-to-moderate GIB.

DESIGN

A single-center prospective study.

PATIENTS

During a 3-year period, 573 patients admitted to the hospital with acute mild-to-moderate GIB were included in this study. Among them, 37 patients (6.5%) with negative endoscopic findings, after urgent upper- and lower-GI endoscopies, underwent CE within the first 48 hours to identify the source of bleeding.

RESULTS

CE revealed active bleeding in 34 patients and a diagnostic yield of 91.9%, including angiodysplasias in 18 patients, ulcers in 3 patients, and tumors in 2 patients. In the remaining 11 patients (32%), CE revealed the site of bleeding: distal duodenum in 1 case (9%), jejunum in 6 cases (54%), ileum in 2 cases (18%), and cecum in 2 cases (18%). From the 37 bleeders, 16 were managed conservatively, 14 endoscopically, and 7 surgically. During a 12-month follow-up period, bleeding recurrence was observed in 5 of 32 (15.6%).

LIMITATIONS

This study had a limited number of patients.

CONCLUSIONS

CE appeared to have a high diagnostic yield in patients with acute, mild-to-moderate, active hemorrhage of obscure origin when performed in the hospital after a negative standard endoscopic evaluation and has important clinical value in guiding medical management.

Authors+Show Affiliations

Department of Gastroenterology, Army Share Fund (NIMTS) Hospital, Athens, Greece.No 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)

Journal Article

Language

eng

PubMed ID

18061718

Citation

Apostolopoulos, Periklis, et al. "Evaluation of Capsule Endoscopy in Active, Mild-to-moderate, Overt, Obscure GI Bleeding." Gastrointestinal Endoscopy, vol. 66, no. 6, 2007, pp. 1174-81.
Apostolopoulos P, Liatsos C, Gralnek IM, et al. Evaluation of capsule endoscopy in active, mild-to-moderate, overt, obscure GI bleeding. Gastrointest Endosc. 2007;66(6):1174-81.
Apostolopoulos, P., Liatsos, C., Gralnek, I. M., Kalantzis, C., Giannakoulopoulou, E., Alexandrakis, G., Tsibouris, P., Kalafatis, E., & Kalantzis, N. (2007). Evaluation of capsule endoscopy in active, mild-to-moderate, overt, obscure GI bleeding. Gastrointestinal Endoscopy, 66(6), 1174-81.
Apostolopoulos P, et al. Evaluation of Capsule Endoscopy in Active, Mild-to-moderate, Overt, Obscure GI Bleeding. Gastrointest Endosc. 2007;66(6):1174-81. PubMed PMID: 18061718.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of capsule endoscopy in active, mild-to-moderate, overt, obscure GI bleeding. AU - Apostolopoulos,Periklis, AU - Liatsos,Christos, AU - Gralnek,Ian M, AU - Kalantzis,Chrissostomos, AU - Giannakoulopoulou,Eleftheria, AU - Alexandrakis,Georgios, AU - Tsibouris,Panagiotis, AU - Kalafatis,Evagelos, AU - Kalantzis,Nikolaos, PY - 2007/02/28/received PY - 2007/06/25/accepted PY - 2007/12/7/pubmed PY - 2008/3/28/medline PY - 2007/12/7/entrez SP - 1174 EP - 81 JF - Gastrointestinal endoscopy JO - Gastrointest Endosc VL - 66 IS - 6 N2 - BACKGROUND: The role of capsule endoscopy (CE) in the diagnosis of active mild-to-moderate GI bleeding (GIB) immediately after a negative EGD and ileocolonoscopy has not been prospectively evaluated. OBJECTIVE: To estimate the diagnostic yield and clinical significance of CE in patients with acute, obscure, overt, mild-to-moderate GIB. DESIGN: A single-center prospective study. PATIENTS: During a 3-year period, 573 patients admitted to the hospital with acute mild-to-moderate GIB were included in this study. Among them, 37 patients (6.5%) with negative endoscopic findings, after urgent upper- and lower-GI endoscopies, underwent CE within the first 48 hours to identify the source of bleeding. RESULTS: CE revealed active bleeding in 34 patients and a diagnostic yield of 91.9%, including angiodysplasias in 18 patients, ulcers in 3 patients, and tumors in 2 patients. In the remaining 11 patients (32%), CE revealed the site of bleeding: distal duodenum in 1 case (9%), jejunum in 6 cases (54%), ileum in 2 cases (18%), and cecum in 2 cases (18%). From the 37 bleeders, 16 were managed conservatively, 14 endoscopically, and 7 surgically. During a 12-month follow-up period, bleeding recurrence was observed in 5 of 32 (15.6%). LIMITATIONS: This study had a limited number of patients. CONCLUSIONS: CE appeared to have a high diagnostic yield in patients with acute, mild-to-moderate, active hemorrhage of obscure origin when performed in the hospital after a negative standard endoscopic evaluation and has important clinical value in guiding medical management. SN - 0016-5107 UR - https://www.unboundmedicine.com/medline/citation/18061718/Evaluation_of_capsule_endoscopy_in_active_mild_to_moderate_overt_obscure_GI_bleeding_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(07)02279-1 DB - PRIME DP - Unbound Medicine ER -