title: Diagnostic yield of capsule endoscopy vs. double-balloon endoscopy for patients who have undergone total enteroscopy with obscure gastrointestinal bleeding.
abstract: OBJECTIVE
  The usefulness of capsule endoscopy (CE) and of double-balloon endoscopy (DBE) for detection of small-bowel lesions is widely accepted. We compared CE- and DBE-based detection of small-bowel lesions in patients with obscure gastrointestinal bleeding (OGIB) who underwent total enteroscopy by both CE and DBE.
  
  
  METHODS
  One hundred eighteen consecutive patients (70 men, 48 women; mean age 62.9±18.4 years) with OGIB underwent both CE and DBE. CE was performed and DBE was then performed within 1 week by both retrograde and antegrade approaches. Differences in detection rates were analyzed.
  
  
  RESULTS
  Overall, small-bowel lesions were detected by CE in 53 patients (44.9%) and by DBE in 63 patients (53.4%) (p=0.01); agreement between CE and DBE findings was good (kappa statistic=0.76). Total enteroscopy was achieved by both modalities in 54 patients; CE detected small-bowel lesions in 25 of these patients (46.3%), and DBE detected lesions in 28 of these patients (51.9%) (p=0.25); agreement between CE and DBE findings was very good (kappa statistic=0.88).
  
  
  CONCLUSIONS
  Our data support preferential use of noninvasive CE for patients with OGIB and subsequent DBE examination in most cases.
authors.affiliation: Department of Gastroenteroogy and Metabolism, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Shishido
authors.forename: Shiro
authors.initials: S
authors.lastname: Oka
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Taiki
authors.initials: T
authors.lastname: Aoyama
authors.forename: Ikue
authors.initials: I
authors.lastname: Watari
authors.forename: Hiroki
authors.initials: H
authors.lastname: Imagawa
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yoshida
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000009:adverse effects / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged