Skip to main content
SpringerLink
Log in

Diagnostic Yield and Impact of Capsule Endoscopy on Management of Patients with Gastrointestinal Bleeding of Obscure Origin

  • Original Paper
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

This study assessed diagnostic yield and impact of capsule endoscopy on patient management. Seventy-five patients with obscure gastrointestinal bleeding were included. Clinical and followup information was collected by review of patient records and with personal contact with the referring physicians. All previous clinical information and interventions after capsule endoscopy and clinical outcome were noted. The indication was obscure-overt gastrointestinal bleeding in 36 patients (48%) and obscure-occult gastrointestinal bleeding in 39 patients (52%). Overall diagnostic yield was 66.7% considering relevant lesions. Followup was available in 31 patients. Capsule endoscopy changed clinical management in 61.4%. Multivariate analysis showed that patients with another potential source of bleeding and patients whose onset was hematochezia were not good candidates for capsule endoscopy. Capsule endoscopy has a high diagnostic yield and a positive influence on clinical management in a high proportion of patients with obscure gastrointestinal bleeding.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Zuckerman GR, Prakash C, Askin MP, Lewis BS (2000) AGA technical review on the evaluation and management of obscure gastrointestinal bleeding. Gastroenterology 118:201– 221

    Article  PubMed  CAS  Google Scholar 

  2. Lewis BS (1994) Small intestinal bleeding. Gastroenterol Clin North Am 23:67–91

    PubMed  CAS  Google Scholar 

  3. Scapa E, Jacob H. Lewkowicz S, Migdal M, Gat D, Gluckhovski A (2002) Initial experience of wireless capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology. Am J Gastroenterol 97:2776– 2779

    Article  PubMed  Google Scholar 

  4. Penazzio M, Santucci R, Rondonotti E, Abbiati C, Beccari G, Rossini F, de Francis R (2004) Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy. Report of 100 consecutive cases. Gastroenterology 126:643–653

    Article  Google Scholar 

  5. Appleyard M, Fireman Z, Glukhovvsky A, Jacob H, Shreiver R, Kadirkamathan S, Lavy A, Lewkowicz S, Scapa E, Shofti R, Swain P, Zaretsky A (2000) A randomized trial comparing wireless capsule endoscopy with push enteroscopy for the detection of small bowel lesions. Gastroenterology 119:1431– 1438

    Article  PubMed  CAS  Google Scholar 

  6. Lewis BS, Swain P (2002) Capsule endoscopy in the evaluation of patients with suspected small intestinal bleeding: results of a pilot study. Gastrointest Endosc 56:349–353

    Article  PubMed  Google Scholar 

  7. Costamagna G, Shah SK, Riccioni ME, Foschia F, Mutignani M, Perri V, Ricioni ME (2002) A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease. Gastroenterology 123:999– 1005

    Article  PubMed  Google Scholar 

  8. Adler DG, Knipschield M, Gostout C (2004) A prospective comparison of capsule endoscopy and push enteroscopy in patients with GI bleeding of obscure origin. Gastrointest Endosc 59:492– 498

    Article  PubMed  Google Scholar 

  9. Eu C, Remke S, May A, Helou L, Henrich R, Mayer G (2002) The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding. Endoscopy 34:685–689

    Article  Google Scholar 

  10. Rastogi A, Schoen RE, Slivka A (2004) Diagnosis yield and clinical outcomes of capsule endoscopy. Gastrointest Endosc 60:959– 964

    Article  PubMed  Google Scholar 

  11. Redondo-Cerezo E, Pérez-Sola A, Gómez C, Pérez-Vigara G, Pérez-García JI, Morillas J (2005) Oesophageal entrapment of wireless capsule endoscopy in valvular patients. Gut 54:309– 310

    Article  PubMed  CAS  Google Scholar 

  12. Ell C, Remke S, May A, Helou L, Henrich R, Mayer G (2002) The first prospective controlled trial comparing wireless capsule endoscopy in chronic gastrointestinal bleeding. Endoscopy 34:685–689

    Article  PubMed  CAS  Google Scholar 

  13. Janowski D, Toth L, Wolff R, Mitty R, Lopez M, Cave DR (2002) Video capsule endoscopy: early observations on its role in the diagnosis and management of obscure gastrointestinal bleeding. Gastroenterology 122:A18 [abstract]

    Google Scholar 

  14. Saurin JC, Delvaux M, Gaudin JL; Fassler I, Villarejo J, Vahedi K, Bitoun A, Canard JM, Souquet JC, Ponchon T, Florent C, Gay G (2003) Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy. Endoscopy 35:576–584

    Article  PubMed  Google Scholar 

  15. Bar-Meir S, Eliakim R, Nadler M, Barkay O, Fireman Z, Scapa E, Chowers Y, Bardan E (2004) Second capsule endoscopy for patients with severe iron deficiency anemia. Gastrointest Endosc 60:711–713

    Article  PubMed  Google Scholar 

  16. American Society for Gastrointestinal Endoscopy (2003) Obscure gastrointestinal bleeding. Gastrointest Endosc 58:650–655

    Article  Google Scholar 

  17. Mata A, Bordas JM, Feu F, Gines M, Pellise M, Fernandez−Esparrach F (2004) Wireless capsule endoscopy in patients with obscure gastrointestinal bleeding: a comparative study with push enteroscopy. Aliment Pharmacol Ther 20:189–194

    Article  PubMed  CAS  Google Scholar 

  18. Moreno C, Arvanitakis M, Deviere J, Van Gossum A (2005) Capsule endoscopy examination of patients with obscure gastrointestinal bleeding: evaluation of clinical impact. Acta Gastroenterol Belg 68:10–14

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Sección de Aparato Digestivo, Unidad de Endoscopias, Hospital General, Virgen de la Luz, Cuenca, 16002, Spain

    Eduardo Redondo-Cerezo, Gracia Pérez-Vigara, Angel Pérez-Sola, Carmen J. Gómez-Ruiz, Miriam Viñuelas Chicano, Natividad Sánchez-Manjavacas, Julia Morillas, José I. Pérez-García & Jesús García-Cano

Authors
  1. Eduardo Redondo-Cerezo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gracia Pérez-Vigara
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Angel Pérez-Sola
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carmen J. Gómez-Ruiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Miriam Viñuelas Chicano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Natividad Sánchez-Manjavacas
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Julia Morillas
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. José I. Pérez-García
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jesús García-Cano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eduardo Redondo-Cerezo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Redondo-Cerezo, E., Pérez-Vigara, G., Pérez-Sola, A. et al. Diagnostic Yield and Impact of Capsule Endoscopy on Management of Patients with Gastrointestinal Bleeding of Obscure Origin. Dig Dis Sci 52, 1376–1381 (2007). https://doi.org/10.1007/s10620-006-9605-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-006-9605-3

Keywords

Search

Navigation