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Obscure gastrointestinal bleeding: single centre experience of capsule endoscopy

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Abstract

The advent of capsule endoscopy (CE) has resulted in a paradigm shift in the approach to the diagnosis and management of patients with obscure gastrointestinal bleeding (OGIB). With increasing global availability of this diagnostic tool, it has now become an integral part of the diagnostic algorithm for OGIB in most parts of the world. However, there is scant data on optimum timing of CE for maximizing diagnostic yield. OGIB continues to be a challenge because of delay in diagnosis and consequent morbidity and mortality. We evaluated the diagnostic yield of CE in identifying the source of bleeding in patients with OGIB. We identified patients who underwent CE at our institution from May 2006 to May 2011. The patients’ medical records were reviewed to determine the type of OGIB (occult, overt), CE results and complications, and timing of CE with respect to onset of bleeding. Out of 346 patients investigated for OGIB, 246 (71.1%) had some lesion detected by CE. In 206 patients (59.5%), definite lesions were detected that could unequivocally explain the OGIB. Small bowel angiodysplasia, ulcer/erosions secondary to Crohn’s disease, non-steroidal anti-inflammatory agent use, and neoplasms were the commonest lesions detected. Visualization of the entire small bowel was achieved in 311 (89.9%) of cases. Capsule retention was noted in five patients (1.4%). In this study, CE was proven to be a safe, comfortable, and effective, with a high rate of accuracy for diagnosing OGIB.

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Acknowledgment

Martina Taglioni and Catleen Tietz for the technical support.

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Authors and Affiliations

  1. Department of Clinical Medicine, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy

    Carlo Calabrese, Giuseppina Liguori, Paolo Gionchetti, Fernando Rizzello & Massimo Campieri

  2. Department of Surgery, University of Bologna, Bologna, Italy

    Silvio Laureti, Massimo Pierluigi Di Simone & Gilberto Poggioli

Authors
  1. Carlo Calabrese
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  2. Giuseppina Liguori
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  3. Paolo Gionchetti
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  4. Fernando Rizzello
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  5. Silvio Laureti
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  6. Massimo Pierluigi Di Simone
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  7. Gilberto Poggioli
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  8. Massimo Campieri
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Correspondence to Carlo Calabrese.

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Calabrese, C., Liguori, G., Gionchetti, P. et al. Obscure gastrointestinal bleeding: single centre experience of capsule endoscopy. Intern Emerg Med 8, 681–687 (2013). https://doi.org/10.1007/s11739-011-0699-z

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  • DOI: https://doi.org/10.1007/s11739-011-0699-z

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