TITLE

A PROSPECTIVE SINGLE BLIND STUDY COMPARING CAPSULE ENTEROSCOPY WITH PUSH ENTEROSCOPY AND SMALL BOWEL ENEMA IN OBSCURE GASTROINTESTINAL BLEEDING

AUTHOR(S)
Georgopoulos, P.; Poon, F.W.; Anderloni, A.; Mackenzie, J.F.; Morris, A.J.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA25
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
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.
ACCESSION #
9747424

 

Related Articles

  • Iron deficiency anaemia, gastritis and antral vascular malformation. Cairns, H. S.; Rees, H.; Bevan, G. // Journal of the Royal Society of Medicine;Jan1986, Vol. 79 Issue 1, p46 

    The article accounts on an unusual cause of chronic gastrointestinal bleeding secondary to an antral vascular malformation in a 35-year-old Iranian woman. Her examination revealed anemia with hypochromic and microcytic film, and upper gastrointestinal endoscopy revealed several bright red linear...

  • Hemosuccus Pancreaticus: A Cause for Obscure Gastrointestinal Bleeding--Diagnosis by Endoscopy and Successful Management by Total Parenteral Nutrition. Morse, John M. D.; Reddy, Kuchikulla R.; Thomas, Eapen // American Journal of Gastroenterology;Sep1983, Vol. 78 Issue 9, p572 

    Hemorrhage through the pancreatic duct (hemosuccus pancreaticus) is discussed in a patient with alcoholic chronic pancreatitis and anemia. The pancreatic duct as the source of bleeding was determined by use of duodenoscopy; ahdominal arteriograms were normal. It is postulated that the patient's...

  • A Prospective Study of Bidirectional Endoscopy (Colonoscopy and Upper Endoscopy) in the Evaluation of Patients with Occult Gastrointestinal Bleeding. Zuckerman, Gary; Benitez, Juan // American Journal of Gastroenterology;Jan1992, Vol. 87 Issue 1, p62 

    One hundred patients with occult gastrointestinal bleeding (OGIB) (i.e., guaiac-positive stools and/or iron deficiency anemia) were prospectively evaluated with bidirectional endoscopy [upper endoscopy (EGD) and colonoscopyl] to determine the origin of occult bleeding. Predetermined criteria...

  • Predictors of Variceal Cause of Upper Gastrointestinal Tract Hemorrhage. Lertsithichai, Panuwat; Tangkittimasak, Suwat; Sumritpradit, Preeda // Thai Journal of Surgery;Jan-Mar2005, Vol. 26 Issue 1, p1 

    Objective: To identify significant pre-endoscopic predictors of variceal cause in patients with acute upper gastrointestinal tract (GI) hemorrhage. Patients and Method: Medical records of 187 patients with primary diagnosis of upper GI hemorrhage treated during the period from May 2003 to July...

  • Diffuse Subcutaneous Air Due to a Perforated Colonic Diverticulum. Lai, Wen; Dowell, Jonathan // New England Journal of Medicine;3/25/2004, Vol. 350 Issue 13, pe12 

    This article presents a case study involving complications from a colonoscopy. An 80-year-old man with multiple medical problems underwent a colonoscopy, which was performed to determine the cause of anemia. When the endoscope was withdrawn, a sigmoid diverticulum with a ragged lining was noted...

  • Small bowel hemangiomas: Diagnostic role of capsule endoscopy. Khanna, Sanat; Kanojia, Ravi P.; Menon, Prema; Rana, Surinder; Thapa, B. R.; Bhasin, D. K.; Rao, K. L. N. // Journal of Indian Association of Pediatric Surgeons;Jul-Sep2010, Vol. 15 Issue 3, p101 

    Vascular anomalies involving the small bowel are an uncommon cause of gastrointestinal bleeding in childhood. We present here an 11-year-old boy who presented with severe anemia and malena. The routine investigations did not reveal any pathology. A capsule endoscopy study was performed, which...

  • Capsule Endoscopy and Left Ventricular Assist Devices. HANSON, BRIAN; KOENE, RYAN; ROY, SAMIT; JOHN, RANJIT; CHAUDHARY, NADHEEM; ECKMAN, PETER; PERALTA, JOSE VEGA // Minnesota Medicine;Jul2015, Vol. 98 Issue 7, p43 

    The article investigates the safety and efficacy of capsule endoscopy (CE) in treating patients with left ventricular assist devices (LVAD). A study was conducted to all LVAD patients of University of Minnesota Medical Center undergoing CE where their clinical data underwent a retrospective...

  • Gastrointestinal bleeding in the tropics: Look for the hookworm. Sharma, Vishal; Gunjan, Deepak; Chhabra, Puneet; Sharma, Ravi; Rana, Surinder Singh; Bhasin, Deepak Kumar // Tropical Doctor;Jan2017, Vol. 47 Issue 1, p48 

    Hookworms are recognised as a cause of iron-deficiency anaemia in endemic areas. They are, however, often not considered in the differential diagnosis of overt gastrointestinal bleeding. We report the endoscopic diagnosis of hookworms as the cause of gastrointestinal bleeding in three patients,...

  • Diagnostic Yield of Capsule Endoscopy in a Tertiary Hospital in Patients with Obscure Gastrointestinal Bleeding. van Turenhout, Sietze T.; Jacobs, Maarten A. J. M.; van Weyenberg, Stijn J.; Herdes, Erik; Stam, Fred; Mulder, Chris J. J.; Bouma, Gerd // Journal of Gastrointestinal & Liver Diseases;Jun2010, Vol. 19 Issue 2, p141 

    Background & Aims. Capsule endoscopy is applicable to several clinical conditions, but obscure gastrointestinal bleeding remains the main indication. This study aims at determining the diagnostic yield of capsule endoscopy for obscure gastrointestinal bleeding using a structured terminology in a...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics