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The role of capsule endoscopy after negative CT enterography in patients with obscure gastrointestinal bleeding.
MedLine Citation:
PMID:  22270143     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: The aim of the present study was to evaluate the role of capsule endoscopy in patients with obscure gastrointestinal bleeding (OGIB) after negative computed tomographic (CT) enterography. METHODS: We retrospectively included 30 patients with OGIB who received capsule endoscopy after negative CT enterography. The median age of the patients was 60 years, and 60% of patients were male. The median follow-up duration was 8 months. Overt bleeding was 60%, and occult bleeding was 40%. RESULTS: Based on capsule endoscopy results, a definitive diagnosis was made for 17 patients (57%): ulcer in nine patients (30%), active bleeding with no identifiable cause in five (17%), angiodysplasia in two (7%) and Dieulafoy's lesion in one (3%). Two patients with jejunal ulcers were diagnosed with Crohn's disease. Seven patients (41%) with positive capsule endoscopy received double balloon enteroscopy and two patients (12%) received steroid treatment for Crohn's disease. Patients with overt bleeding, a previous history of bleeding, or who received large amounts of blood transfusions were more likely to show positive capsule endoscopy. CONCLUSIONS: Capsule endoscopy showed high diagnostic yields in patients with OGIB after negative CT enterography and may help to provide further therapeutic plans for patients with OGIB and negative CT enterography. KEY POINTS : • CT enterography has been widely used in evaluating obscure gastrointestinal bleeding (OGIB). • Capsule endoscopy showed high diagnostic yield for OGIB after negative CT enterography. • Negative CT enterography does not exclude important causes of small bowel bleeding. • Most lesions missed at CT-enterography are flat and can be detected by capsule endoscopy.
Authors:
Hyun Mi Heo; Chan Hyuk Park; Joon Seok Lim; Jin Ha Lee; Bo Kyung Kim; Jae Hee Cheon; Tae Il Kim; Won Ho Kim; Sung Pil Hong
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-22
Journal Detail:
Title:  European radiology     Volume:  -     ISSN:  1432-1084     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114774     Medline TA:  Eur Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, South Korea.
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