[Analysis of the factors that affect the diagnostic yield of capsule endoscopy in patients with obscure gastrointestinal bleeding].
OBJECTIVE
Capsule endoscopy (CE) has become a valuable modality for the detection of small bowel lesions. The usefulness of CE for obscure gastrointestinal (GI) bleeding has been established with an overall diagnostic yield of 60%. It is unknown whether CE is of equal value in all the patients or of greater benefit in selected groups in Korea. We evaluated the factors that affect the diagnostic yields of CE in patients with obscure GI bleeding.


METHODS
CE was performed in 126 consecutive patients [74 men and 52 women mean age 52.5 years (25-75 yrs), 23 with active bleeding] with obscure GI bleeding between September 2002 and July 2004. Patients were divided into two groups: those with documented bleeding lesions and those with non specific CE findings. We analyzed the clinical characteristics and other parameters that influenced the diagnostic yields of CE.


RESULTS
A definite or probable cause for obscure GI bleeding was found in 69% (80/116) of the patients. NSAID induced ulcer (16.4%) and angiodysplasia (12.1%) were the most common diagnoses. In patients with active bleeding, the diagnostic yield was significantly greater than that of the patients with occult bleeding (80% vs. 68.3%, p<0.05). However, there was no significant difference in parameters between patients with abnormal CE and those with normal CE in respect to gender, age, previous bleeding history, need for transfusion, cecum imaging, and bowel preparation.


CONCLUSIONS
The diagnostic yield of CE in patients with obscure GI bleeding is 69%. It is significantly higher in patients with active bleeding.
Lee
Beom Jae
BJ
Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea.
Chun
Hoon Jai
HJ
Koo
Ja Soul
JS
Keum
Bora
B
Park
Sang Hoon
SH
Kim
Du Rang
du R
Kwon
Yong Dae
YD
Kim
Yong Sik
YS
Jean
Yoon Tae
YT
Lee
Hong Sik
HS
Um
Soon Ho
SH
Lee
Sang Woo
SW
Choi
Jai Hyun
JH
Kim
Chang Duck
CD
Ryu
Ho Sang
HS
D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity