title: Single-centre experience on use of videocapsule endoscopy for obscure gastrointestinal bleeding in 120 consecutive patients.
abstract: OBJECTIVE
  Capsule endoscopy (CE) has become first choice for evaluation of the small bowel in case of obscure gastrointestinal bleeding (OGIB). The influence of clinical factors on CE diagnostic yield remains controversial and little is known about the exact impact of CE on management and outcome. We aimed to identify the ideal candidates for CE examination in daily practice by reviewing our own data and the available literature.
  
  
  METHODS
  We retrospectively analyzed data of 120 consecutive patients with OGIB (33 overt - 87 occult) that underwent CE in a single centre.
  
  
  RESULTS
  Complete evaluation of the small bowel was achieved in 82.5%, with only one case of capsule retention. The overall diagnostic yield was 47.5% and no difference was noted in the overt versus the occult group. Only the presence of cardiovascular comorbidity was associated with a statistically significant increase in diagnostic yield (p = 0,041). Arterio-venous malformation (AVM) was diagnosed most frequently in 68.4% of positive studies. Specific management alterations were made in 22 patients (18.3%) following CE, mostly guided by a positive result (91%) (p = 0,0001).
  
  
  CONCLUSIONS
  In daily practice it remains very difficult to predict pathology detection rate on CE as well as to estimate the impact on further management and outcome in the individual patient. Diagnostic yield is significantly higher in patients with cardiovascular comorbidity than in those without.
authors: Department of Gastroenterology, Imelda General Hospital, Bonheiden, Belgium. pieter_jan_c@hotmail.com
authors: P J
authors: PJ
authors: Cuyle
authors: N
authors: N
authors: Schoofs
authors: P
authors: P
authors: Bossuyt
authors: V
authors: V
authors: Moons
authors: G
authors: G
authors: Van Olmen
authors: M
authors: M
authors: Hiele
authors: P
authors: P
authors: Christiaens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000473:pathology*; D006801:Humans; D007410:Intestinal Diseases / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult