Georgopoulos, P.; Poon, F.W.; Anderloni, A.; Mackenzie, J.F.; Morris, A.J.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA25
Academic Journal
Background: Obscure Gl bleeding remains a clinical problem in up to 10% of patients with anaemia with the small bowel as the most possible source of bleeding. Wireless capsule endoscopy has not been evaluated in comparison with the established methods of small bowel examination, enteroscopy, and small bowel enema in anaemic patients. Aim: To compare prospectively the diagnostic yield of capsule enteroscopy with push enteroscopy and small bowel enema. Method: Patients with obscure Gl bleeding with negative upper Gl endoscopy and colonoscopy were studied. Each examination was performed and reported independently by physician or radiologist. Results: Preliminary data from the first 9 enrolled patients are presented. Mean age was 63.5 years (range 58-79) and male to female ratio was 1:2. Comorbitity existed in 5/9 (55.5%) patients with polycystic kidneys (1), previous gastric operation for peptic disease (2), right hemicolectomy (1), and cardiac valve replacement (2). Push enteroscopy discovered a definite bleeding source in 4/9 patients and a possible in one. Capsule enteroscopy found a definite bleeding source in 7/9 patients and a possible cause in one. Six of them had a definite lesion beyond the reachable area of the enteroscope. Other findings not related with bleeding source were found in one patient in each method. None of the patients had abnormal small bowel enema findings. The diagnostic yield of push enteroscopy was 44.4% in comparison to capsule enteroscopy, which was 77.7%. Additional information within the small intestine was obtained using the capsule enteroscopy in 66.6% of the patients. Conclusion: This prospective single blind study shows For first time that capsule enteroscopy detects more lesions than push enteroscopy or small bowel enema in patients with obscure Gl bleeding. It can also diagnose intestinal bleeding source beyond the reach of push enteroscopy in a substantial larger number of patients.


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