The impact of capsule endoscopy on surgical results in patients with obscure gastrointestinal bleeding.
BACKGROUND
Obscure gastrointestinal bleeding (OGIB) that cannot be established applying traditional endoscopic methods represents 5 % of all gastrointestinal bleedings. Earlier, in cases of recurrent, overt bleedings the surgeons had to perform a laparotomy "blind" without diagnosis. The aim of our retrospective study was to analyse the effectiveness of surgical therapy in patients with OGIB investigated with capsule endoscopy (CE).


METHODS
During 36-month period at two workplaces capsule endoscopy studies were evaluated in 61 patients with OGIB who had undergone non-diagnostic panendoscopy and colonoscopy. CE findings were divided into three groups according to the bleeding source: definitive bleeding source (48), uncertain bleeding potential (5) and negative findings (8). Surgical therapy was initiated in 18 cases with definitive bleeding sources.


RESULTS
The mean age of 7 male and 11 female patients operated on was 63.4 (+/- 10.69) years. The period between the first clinical symptoms and the date of the operation was an average of 18.2 (+/- 26.11) months. During this period patients were hospitalized in an average of 6 (+/- 7.96) cases. In 17 cases (94 %) the surgical and pathological findings justified the definitive bleeding sources detected by CE. In one case of bleeding angiodysplasia with negative pathological findings the follow-up period without recurrent bleeding justified the validity of CE results and the success of surgical therapy.


CONCLUSIONS
CE offers a high impact on the surgical results in patients with OGIB. Through our CE examinations the correct localization of the bleeding sources always provided a reasonable support to perform an optimal small bowel resection.
Second Department of Internal Medicine, Vaszary Kolos Hospital, Hungary. drmarta.kovacs@t-online.hu
M
M
Kovács
P
P
Pák
G
G
Pák
A
A
Oláh
I
I
Rácz
D000368:Aged; D016888:Angiodysplasia / Q000175:diagnosis / Q000601:surgery; D053704:Capsule Endoscopy; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012008:Recurrence; D012680:Sensitivity and Specificity