title: Is there a difference between capsule endoscopy and computed tomography as a first-line study in obscure gastrointestinal bleeding?
abstract: OBJECTIVE
  Capsule endoscopy (CE) is currently recommended as the first-line study in the evaluation of obscure gastrointestinal bleeding (OGIB), while computed tomography (CT) is often thought of as complementary to CE. This study evaluated CT as a first-line study in OGIB and compared it with CE.
  
  
  METHODS
  Ninety-nine patients with OGIB who received both CE and CT were included. CT included conventional CT and CT enterography (CTE). Patients were divided into two groups: the CT before CE group (CT first group n=75) and the CE before CT group (CE first group n=24). The two groups were compared retrospectively.
  
  
  RESULTS
  Overt OGIB was present in 92% of patients. Mucosal lesions (46%) were the most common diagnoses, while tumors accounted for 7%. The diagnostic yield of CE was significantly higher than that of CT for both groups (CT first group, p<0.001; CE first group, p=0.013). In the CT first group, the diagnostic yield using both CT and CE (48/75; 64%) was significantly higher than that for CT alone (12/75; 16%, p=0.005). In the CE first group, the diagnostic yield with both CT and CE versus CE alone was 70.9% versus 62.5%, respectively, with a significant difference (p=0.045).
  
  
  CONCLUSIONS
  There was no significant clinical difference associated with the order in which the tests were performed. However, CE and CT, when used together, had a significantly greater diagnostic yield than did CE or CT when used alone.
authors.affiliation: Department of Internal Medicine, Digestive Disease Center, Institute of Digestive Research, Seoul, Republic of Korea. jokim@schmc.ac.kr.
authors.forename: Seong Ran
authors.initials: SR
authors.lastname: Jeon
authors.forename: Kim
authors.initials: K
authors.lastname: Jin-Oh
authors.forename: Kim Hyun
authors.initials: KH
authors.lastname: Gun
authors.forename: Lee Tae
authors.initials: LT
authors.lastname: Hee
authors.forename: Cho
authors.initials: C
authors.lastname: Jun-Hyung
authors.forename: Park Eui
authors.initials: PE
authors.lastname: Ju
authors.forename: Lim Dae
authors.initials: LD
authors.lastname: Seop
authors.forename: Kim Wan
authors.initials: KW
authors.lastname: Jung
authors.forename: Ko Bong
authors.initials: KB
authors.lastname: Min
authors.forename: Cho Joo
authors.initials: CJ
authors.lastname: Young
authors.forename: Lee Joon
authors.initials: LJ
authors.lastname: Seong
authors.forename: Lee Moon
authors.initials: LM
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D016888:Angiodysplasia / Q000150:complications / Q000175:diagnosis*; D053704:Capsule Endoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010437:Peptic Ulcer / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods