Document Detail


Capsule endoscopy versus push enteroscopy in patients with occult gastrointestinal bleeding.
MedLine Citation:
PMID:  12772049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Wireless capsule endoscopy is a new method enabling non-invasive diagnostic endoscopy of the entire small intestine. In this study we prospectively examined the diagnostic precision of capsule endoscopy compared with push enteroscopy in patients with occult gastrointestinal bleeding. METHODS: Between July 2001 and October 2002 we examined 48 patients with suspected disorders of the small intestine using capsule endoscopy. 33 patients with obscure bleeding (19 men, 14 women, mean age 58 +/- 23 years) were prospectively examined using capsule endoscopy and push enteroscopy. RESULTS: On average, the patients had been suffering from chronic gastrointestinal bleeding for 30 +/- 36 (1-120) months. The lowest haemoglobin level was 6.5 +/- 1.6 g/dl (2.3-9.6) and on average 9 +/- 10 (0-50) blood units were transfused. Each patient underwent 4 +/- 2 (1-10) hospitalisations, with a mean 9 +/- 4 (5-17) diagnostic procedures before capsule endoscopy was used. Definitive bleeding sites were diagnosed by push enteroscopy in 7 patients (angiodysplasia [n = 5], ulcers [n = 1], multiple jejunal diverticula [n = 1]). Capsule endoscopy showed a bleeding source in 25 cases (76 %) (angiodysplasias [n = 15], Meckel's diverticulum [n = 1], ulcers [n = 7], ileum diverticulosis [n = 1], B-cell lymphoma [n = 1]). Push enteroscopy localised an additional bleeding source in comparison with capsule endoscopy (multiple jejunal diverticula) in one patient. Both methods of examination were safe and showed no complications. DISCUSSION: The present study shows that capsule endoscopy had the highest diagnostic yield and was superior to push enteroscopy in patients with chronic gastrointestinal bleeding. By using the capsule at an early stage the subsequent therapeutic procedure could be considerably shortened and diagnostic processes could possibly be optimised.
Authors:
D Hartmann; D Schilling; G Bolz; M Hahne; R Jakobs; E Siegel; U Weickert; H E Adamek; J F Riemann
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Zeitschrift für Gastroenterologie     Volume:  41     ISSN:  0044-2771     ISO Abbreviation:  Z Gastroenterol     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-28     Completed Date:  2003-12-08     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0033370     Medline TA:  Z Gastroenterol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  377-82     Citation Subset:  IM    
Affiliation:
Department of Medicine C, Gastroenterology, Klinikum der Stadt Ludwigshafen gGmbH, Academic Hospital of the Johannes-Gutenberg-University of Mainz, Ludwigshafen, Germany. MedCLu@t-online.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Capsules
Chronic Disease
Diagnosis, Differential
Endoscopes, Gastrointestinal*
Equipment Design
Female
Gastrointestinal Hemorrhage / etiology*,  pathology,  surgery
Humans
Image Processing, Computer-Assisted / instrumentation*
Intestinal Diseases / diagnosis*,  pathology,  surgery
Intestinal Mucosa / pathology,  surgery
Intestine, Small* / pathology,  surgery
Male
Middle Aged
Prospective Studies
Sensitivity and Specificity
Video Recording / instrumentation*
Chemical
Reg. No./Substance:
0/Capsules

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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