title: Diagnostic yield and clinical outcomes after capsule endoscopy in 100 consecutive patients with obscure gastrointestinal bleeding.
abstract: OBJECTIVE
  The endoscopic capsule is a useful tool for visualizing the small bowel in patients with obscure gastrointestinal bleeding. In this study the authors evaluated the diagnostic aid provided by the endoscopic capsule, the factors predicting a significant finding and their impact on the patients' clinical evolution.
  
  
  METHODS
  A total of 100 patients (52 men and 48 women, average age 64.4 years) underwent capsule endoscopy. Of this group, 52 patients presented with obscure-overt bleeding and 48 with obscure-occult bleeding. After an average follow-up time of 11.4 months, the clinical outcome was evaluated in 95 patients.
  
  
  RESULTS
  The endoscopic capsule identified significant findings in 68% of patients. The most common diagnosis (33.8%) was angiodysplasias. The most important factor predicting significant findings was the previous need for transfusion in the overt bleeding group. As the result of the findings, a specific intervention was made in 75.8% of patients. At the end of follow-up, the clinical outcome was considered positive in 71.6% of patients. Capsule retention occurred in one patient, who required surgery.
  
  
  CONCLUSIONS
  In patients with obscure gastrointestinal bleeding, capsule endoscopy provides a high degree of diagnostic aid. The best candidates for this procedure are patients with obscure-overt bleeding who have required blood transfusions. Capsule endoscopy has a positive influence on an important proportion of patients, whether oriented towards new diagnostic techniques or towards a definitive treatment.
authors.affiliation: Department of Gastroenterology, Complexo Hospitalario Juan Canalejo, A Coruña, Spain. estevez@canalejo
authors.forename: Emilio
authors.initials: E
authors.lastname: Estévez
authors.forename: Benito
authors.initials: B
authors.lastname: González-Conde
authors.forename: José Luis
authors.initials: JL
authors.lastname: Vázquez-Iglesias
authors.forename: Maria
authors.initials: M
authors.lastname: de Los Angeles Vázquez-Millán
authors.forename: Sonia
authors.initials: S
authors.lastname: Pértega
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Alonso
authors.forename: Joan
authors.initials: J
authors.lastname: Clofent
authors.forename: Eva
authors.initials: E
authors.lastname: Santos
authors.forename: José Luis
authors.initials: JL
authors.lastname: Ulla
authors.forename: Eloy
authors.initials: E
authors.lastname: Sánchez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D053704:Capsule Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D016896:Treatment Outcome