| Diagnostic Yield of Dual-Phase CT Enterography in Patients with Obscure Gastrointestinal Bleeding and a Nondiagnostic Capsule Endoscopy. | |
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MedLine Citation:
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PMID: 22098076 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background and aims: In patients with obscure gastrointestinal bleeding, capsule endoscopy is widely used to determine the source of bleeding. However, there is currently no consensus on how to further evaluate patients with obscure gastrointestinal bleeding with a nondiagnostic capsule endoscopy examination. This study aims to determine the diagnostic yield of dual-phase computed tomographic (CT) enterography in patients with obscure gastrointestinal bleeding and a nondiagnostic capsule endoscopy. Methods: Patients with obscure gastrointestinal bleeding who were referred for capsule endoscopy were prospectively enrolled. Obscure gastrointestinal bleeding was defined as overt if there was obvious gastrointestinal bleeding; otherwise it was defined as occult. Patients with a nondiagnostic capsule endoscopy and no contraindications underwent a CT enterography. Results: Capsule endoscopy was performed in 52 patients; 26 patients (50%) had occult gastrointestinal bleeding and 26 patients (50%) had overt gastrointestinal bleeding. CT enterography was then performed in 25 of the 48 patients without a definitive source of bleeding seen on capsule endoscopy. The diagnostic yield of CT enterography was 0% (0/11) in patients with occult bleeding versus 50% (7/14) in patients with overt bleeding (p < 0.01). Using clinical follow-up as the gold standard, for the 25 patients with a nondiagnostic capsule, CT enterography had a sensitivity of 33% (95% CI 0.15, 0.56) and a specificity of 75% (95% CI 0.22, 0.99). Conclusions: In patients with a nondiagnostic capsule endoscopy examination, CT enterography is useful for detecting a source of gastrointestinal bleeding in patients with overt, but not occult, obscure gastrointestinal bleeding. |
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Authors:
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Jaya R Agrawal; Anne C Travis; Koenraad J Mortele; Stuart G Silverman; Rie Maurer; Sarathchandra I Reddy; John R Saltzman |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-18 |
Journal Detail:
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Title: Journal of gastroenterology and hepatology Volume: - ISSN: 1440-1746 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8607909 Medline TA: J Gastroenterol Hepatol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd. |
Affiliation:
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Gastroenterology Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. |
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