Diagnostic yield and clinical outcomes after capsule endoscopy in 100 consecutive patients with obscure gastrointestinal bleeding

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Abstract

Objectives

The endoscopic capsule is a useful tool for visualizing the small bowel in patients with obscure gastrointestinal bleeding. In this study the authors evaluated the diagnostic aid provided by the endoscopic capsule, the factors predicting a significant finding and their impact on the patients' clinical evolution.

Methods

A total of 100 patients (52 men and 48 women, average age 64.4 years) underwent capsule endoscopy. Of this group, 52 patients presented with obscure–overt bleeding and 48 with obscure–occult bleeding. After an average follow-up time of 11.4 months, the clinical outcome was evaluated in 95 patients.

Results

The endoscopic capsule identified significant findings in 68% of patients. The most common diagnosis (33.8%) was angiodysplasias. The most important factor predicting significant findings was the previous need for transfusion in the overt bleeding group. As the result of the findings, a specific intervention was made in 75.8% of patients. At the end of follow-up, the clinical outcome was considered positive in 71.6% of patients. Capsule retention occurred in one patient, who required surgery.

Conclusion

In patients with obscure gastrointestinal bleeding, capsule endoscopy provides a high degree of diagnostic aid. The best candidates for this procedure are patients with obscure–overt bleeding who have required blood transfusions. Capsule endoscopy has a positive influence on an important proportion of patients, whether oriented towards new diagnostic techniques or towards a definitive treatment.

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