Capsule endoscopy examination of patients with obscure gastrointestinal bleeding: evaluation of clinical impact.
BACKGROUND
Wireless video capsule endoscopy (WVCE) has been reported to contribute to the diagnostic management of patients with obscure gastrointestinal bleeding (OGB). Nevertheless, clinical impact data is lacking. The aim of our study was to determine the clinical outcome of patients undergoing WVCE for OGB.


METHODS
38 patients who were referred for OGB and who underwent WVCE examination were included in this study. A questionnaire was sent to the referring doctors after the capsule investigation. The following items were investigated: the final diagnosis of OGB, treatment applied and clinical outcome.


RESULTS
Data was recorded for 26 patients out of 38 (17F, 9M). The mean age was 63 years (range, 21-84). A positive finding was noted in 11 patients. Findings included small bowel lesions in 7 cases and gastroduodenal lesions in 4 cases. As a result of the capsule investigation, specific therapy was administered in 9 patients. Six of the 9 patients treated had no further anemia. Final diagnosis of OGB was in agreement with positive findings of WVCE in all these 11 patients. Among the 15 patients with a negative WVCE, 9 had a digestive lesion (3 small bowel lesions) as a final diagnosis.


CONCLUSIONS
Patients with a positive result at WVCE had further intervention in 82% and were successfully treated in 67% of cases. We had no false positive results in this study, which suggest a high positive predictive value of WVCE. Moreover, negative WVCE had also an indirect clinical impact.
Moreno
C
C
Department of Gastroenterology, Erasme University Hospital, Brussels, Belgium. cmoreno@ulb.ac.be
Arvanitakis
M
M
Devière
J
J
Van Gossum
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D019723:Endoscopes; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014741:Video Recording