Document Detail

A prospective two-center study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding.
MedLine Citation:
PMID:  15933683     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Capsule endoscopy enables noninvasive diagnostic examination of the entire small intestine. However, sensitivity and specificity of capsule endoscopy have not been adequately defined. We, therefore, compared capsule endoscopy by using intraoperative enteroscopy as a criterion standard in patients with obscure GI bleeding. METHODS: Forty-seven consecutive patients with obscure GI bleeding (11 with ongoing overt bleeding, 24 with previous overt bleeding, and 12 with obscure-occult bleeding) from two German gastroenterologic centers were included. All patients who had a prior nondiagnostic evaluation, including upper endoscopy, colonoscopy with a retrograde examination of the distal ileum, and push enteroscopy, underwent capsule endoscopy followed by intraoperative enteroscopy. RESULTS: Capsule endoscopy identified lesions in 100% of the patients with ongoing overt bleeding, 67% of the patients with previous overt bleeding, and 67% of the patients with obscure-occult bleeding. Angiectasias were the most common source of bleeding (n = 22). Capsule endoscopy showed the source of bleeding in 74.4% of all patients. The method was more effective in patients with ongoing bleeding. Compared with intraoperative enteroscopy sensitivity, specificity, and positive and negative predictive values of capsule endoscopy were 95%, 75%, 95%, and 86%, respectively. CONCLUSIONS: Capsule endoscopy has high sensitivity and specificity to detect a bleeding source in patients with obscure GI bleeding. Thus, wireless capsule endoscopy can be recommended as part of the routine work-up in patients with obscure GI bleeding.
Dirk Hartmann; Harald Schmidt; Georg Bolz; Dieter Schilling; Frank Kinzel; Axel Eickhoff; Winfried Huschner; Kathleen Möller; Ralf Jakobs; Peter Reitzig; Uwe Weickert; Klaus Gellert; Harald Schultz; Klaus Guenther; Hartmut Hollerbuhl; Klaus Schoenleben; Hans-Joachim Schulz; Juergen F Riemann
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  61     ISSN:  0016-5107     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-03     Completed Date:  2005-09-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  826-32     Citation Subset:  IM    
Department of Gastroenterology, Academic Teaching Hospital, Ludwigshafen, Germany.
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MeSH Terms
Aged, 80 and over
Endoscopes, Gastrointestinal*
Endoscopy, Gastrointestinal / methods*
Equipment Design
Gastrointestinal Hemorrhage / diagnosis*
Intestinal Diseases / diagnosis
Intestine, Small / pathology
Melena / diagnosis
Middle Aged
Occult Blood
Predictive Value of Tests
Prospective Studies
Radiology, Interventional*
Sensitivity and Specificity
Telangiectasis / diagnosis

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

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