Document Detail

A single-center experience of 260 consecutive patients undergoing capsule endoscopy for obscure gastrointestinal bleeding.
MedLine Citation:
PMID:  17100969     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Capsule endoscopy (CE) has revolutionized the evaluation of obscure gastrointestinal bleeding (OGIB) but published literature is limited to small series with heterogeneous indications. The aim of this study was to determine the findings and the diagnostic yield of CE in a large series of patients with overt and occult OGIB. METHODS: Data on 260 patients who underwent CE for overt (N = 126) or occult (N = 134) OGIB were obtained by retrospective chart review and review of an internal database of CE patients and findings. RESULTS: Visualization of the entire small bowel was achieved in 74%. The majority of exams (66%) were rated as having a good or excellent prep. Clinically significant positive findings occurred in 53%. The yield of CE in the obscure-overt group was greater than in the obscure-occult group (60%vs 46%, P= 0.03). Small bowel angioectasias were the most common finding, comprising over 60% of clinically significant lesions. The mean follow-up was 9.6 months, and there were significant reductions in hospitalizations, additional tests/procedures, and units of blood transfused after CE. Both before and after CE, patients in the overt group had more significant GI bleeding than patients in the occult group. Complications occurred in five (1.9%) cases: nonnatural excretion (four) and CE impaction at cricopharyngeus (one). CONCLUSIONS: The yield of clinically important findings on CE in patients with OGIB is 53% and is greater in patients with obscure-overt than obscure-occult GI bleeding. Angioectasias account for the majority of significant lesions in both groups. Compared with pre-CE, patients had clinical improvement post-CE in medical interventions for OGIB. Complications of CE occur in less than 2% of cases.
Elizabeth J Carey; Jonathan A Leighton; Russell I Heigh; Arthur D Shiff; Virender K Sharma; Janice K Post; David E Fleischer
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Publication Detail:
Type:  Journal Article     Date:  2006-11-13
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  102     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-02-01     Completed Date:  2007-03-16     Revised Date:  2008-06-10    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  89-95     Citation Subset:  IM    
Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona 85259, USA.
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MeSH Terms
Aged, 80 and over
Blood Transfusion / statistics & numerical data
Capsule Endoscopy* / adverse effects
Gastrointestinal Hemorrhage / diagnosis*
Hospitalization / statistics & numerical data
Intestine, Small
Logistic Models
Middle Aged
Retrospective Studies
Comment In:
Acta Gastroenterol Latinoam. 2007 Sep;37(3):192-7   [PMID:  17955731 ]
Am J Gastroenterol. 2007 Jun;102(6):1329-30   [PMID:  17531021 ]

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