Diagnostic yield and therapeutic implications of capsule endoscopy in obscure gastrointestinal bleeding.
OBJECTIVE
The main aim of this study was to evaluate efficacy and therapeutic impact of capsule endoscopy (CE) in obscure gastrointestinal bleeding (OGIB). In addition, we evaluated the software of automatic detection of red zones (SBI, Given Imaging).


METHODS
From June 2002 to June 2003, thirty-five patients with OGIB underwent capsule endoscopy after negative upper and lower digestive endoscopy. Capsule endoscopy was performed following a 12-hour fasting period and some received 2 L of PEG the night before for bowel preparation.


RESULTS
CE was performed for occult (N=18) or overt (N=17) OGIB. Potentially bleeding lesions were found in 16/35 patients (45.7%). Lesions were angiodysplasias (N=8), ulcerations (N=4), tumors (N=2) and active bleeding without visible lesion (N=2). Lesions were located in gastric antrum (N=1), duodenum (N=2) and jejuno-ileum (N=13). Endoscopic (N=10), surgical (N=2) or medical (N=1) treatments were performed in 13/35 (37%). SBI was retrospectively evaluated in 24 patients with sensitivity, specificity, positive and negative predictive value of respectively 45%, 73%, 50% and 69%. CE retention during 10 days occurred in a patient with a small bowel NSAID-induced stricture.


CONCLUSIONS
CE is a safe and effective procedure in the management of OGIB and had a therapeutic impact in more than one third of patients.
Ben Soussan
Emmanuel
E
Département d'Hépatogastroentérologie et de Nutrition, Groupe de Recherche sur l'Appareil Digestif EA 3234, Hôpital C. Nicolle, 1 rue de Germont, 76031 Rouen Cedex.
Antonietti
Michel
M
Hervé
Sophie
S
Savoye
Guillaume
G
Ramirez
Simon
S
Lecleire
Stéphane
S
Ducrotté
Philippe
P
Lerebours
Eric
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020776:Endoscopes, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged