title: [Diagnosis agreement between capsule endoscopy and double-balloon enteroscopy in obscure gastrointestinal bleeding at a referral center].
abstract: Capsule endoscopy and double balloon enteroscopy are well-recognized procedures in obscure gastrointestinal bleeding, with many factors that may influence their diagnosis yield. The aim of the present study was to characterize the degree of agreement between both techniques with focus on the type of lesion in a large cohort of patients at a referral center.
  
  
  
  One thousand two hundred and nine capsules were administered in 1,078 patients and 381 enteroscopies were performed in 361 patients with obscure-gastrointestinal bleeding from 2004 to 2014.
  
  
  
  Both procedures were carried out in 332 patients (mean age: 65.22 +/- 15.41, 183 men) and they have a similar diagnosis yield (70.5% vs. 69.6%, p = 0.9). Overall enteroscopy diagnosis yield was higher within patients with a previous positive capsule endoscopy (79.3% vs. 27.9%, p < 0.001). The degree of agreement was very good for polyps (0.89 [95% CI: 0.78-0.99]), good for vascular lesions (0.66 [95% CI: 0.55-0.77]) and tumors(0.66 [95% CI: 0.55-0.76]) and moderate for ulcers (0.56 [95% CI: 0.46-0.67]). Diverticula (0.39 [95% CI: 0.29-0.5]) achieved a fair agreement. The results of CE and DBE differed in 73 patients (22%).
  
  
  
  The present study confirms that although overall diagnostic yield by capsule endoscopy and double-balloon enteroscopy is similar, there are many factors which can modify these values, mainly the type of lesion.
authors.forename: Enrique
authors.initials: E
authors.lastname: Pérez-Cuadrado-Robles
authors.forename: Pilar
authors.initials: P
authors.lastname: Esteban-Delgado
authors.forename: Blanca
authors.initials: B
authors.lastname: Martínez-Andrés
authors.forename: Luis Eduardo
authors.initials: LE
authors.lastname: Zamora-Nava
authors.forename: José Luis
authors.initials: JL
authors.lastname: Rodrigo-Agudo
authors.forename: Silvia
authors.initials: S
authors.lastname: Chacón-Martínez
authors.forename: Emilio
authors.initials: E
authors.lastname: Torrella-Cortes
authors.forename: Jamal
authors.initials: J
authors.lastname: Shanabo
authors.forename: Antonio
authors.initials: A
authors.lastname: López-Higueras
authors.forename: Eduardo
authors.initials: E
authors.lastname: Muñoz-Bertrán
authors.forename: Hacibe
authors.initials: H
authors.lastname: Hallal
authors.forename: Rafael
authors.initials: R
authors.lastname: Latorre
authors.forename: Octavio
authors.initials: O
authors.lastname: López-Albors
authors.forename: Federico
authors.initials: F
authors.lastname: Soria
authors.forename: Paloma
authors.initials: P
authors.lastname: Bebia-Conesa
authors.forename: Enrique
authors.initials: E
authors.lastname: Pérez-Cuadrado-Martínez
mesh_terms: D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy; D058582:Double-Balloon Enteroscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D062606:Tertiary Care Centers