Long-term follow-up of patients with obscure gastrointestinal bleeding after negative capsule endoscopy.
OBJECTIVE
Capsule endoscopy (CE) is one of the widely accepted investigations for obscure gastrointestinal bleeding (OGIB), but little is known about the impact of CE on the long-term outcome of patients with OGIB. We studied the long-term outcome of patients with OGIB after CE examination.


METHODS
Forty-nine consecutive patients (45% men, mean age 58.3 yr) who underwent CE for OGIB were studied. The most clinically relevant finding that was related to bleeding was identified by CE. All patients were followed up for at least 12 months for clinical overt and occult bleeding.


RESULTS
The median follow-up was 19 months (range 12 to 31). Possible bleeding lesions were detected by CE in 31 (63.3%) patients, and 15 (30.6%) patients, underwent further interventions including laparotomy and push enteroscopy. The overall long-term rebleeding rate in this cohort was 32.7%. The cumulative rebleeding rate was significantly lower in patients with a negative CE (5.6%) than in patients with a positive CE (48.4%, p=0.03 log-rank test). The sensitivity and negative predictive value of CE in predicting rebleeding were 93.8% and 94.4%, respectively.


CONCLUSIONS
Patients with OGIB and negative CE had a very low rebleeding rate, and further invasive investigations can be deferred.
Lai
Larry H
LH
Institute of Digestive Diseases, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China.
Wong
Grace L H
GL
Chow
Dorothy K L
DK
Lau
James Y W
JY
Sung
Joseph J Y
JJ
Leung
Wai K
WK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D018709:Statistics, Nonparametric