Diagnostic Yield and Clinical Impact of Capsule Endoscopy in Obscure Gastrointestinal Bleeding during Routine Clinical Practice: A Single-Center Experience

Katsinelos, Panagiotis; Chatzimavroudis, Grigoris; Terzoudis, Sotiris; Patsis, Ioannis; Fasoulas, Kostas; Katsinelos, Taxiarchis; Kokonis, George; Zavos, Christos; Vasiliadis, Themistoklis; Kountouras, Jannis

doi:10.1159/000322071

Cited by 28 publications

(26 citation statements)

References 42 publications

(29 reference statements)

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“…It was reported that positive CE findings led to a specific therapy that resolved the underlying disease or improved the clinical condition in 71.4% of OGIB patients after a mean follow-up time of 11.8 months [13]. Lai et al [14] suggested that the re-bleeding rate in OGIB patients with negative CE findings was significantly lower than that in patients with positive CE findings (5.6 vs. 48.4%, respectively; p = 0.03).…”

Section: Utility Of Ce In Ogibmentioning

confidence: 99%

Clinical Utility of Capsule Endoscopy and Double-Balloon Enteroscopy in the Management of Obscure Gastrointestinal Bleeding

et al. 2018

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Background: Obscure gastrointestinal bleeding (OGIB) is a common but embarrassing problem for gastroenterologists. Most bleeding lesions associated with OGIB are present in the small intestine and sometimes cannot be identified due to the difficulty associated with physical accessibility. Capsule endoscopy (CE) and double-balloon enteroscopy (DBE) have enabled in the process of diagnosing and have evolved to become approaches to treating OGIB. Summary: CE is a minimally invasive procedure and has a high diagnostic yield in patients with OGIB. DBE offers additional advantage of biopsy collection for pathological diagnosis and therapeutic intervention, but it should be noted that it sometimes causes severe adverse events such as acute pancreatitis, intestinal bleeding, and intestinal perforation. CE should be performed early in the workup course of OGIB. Positive CE findings enhance the diagnostic yield of subsequent DBE, and the effective therapeutic intervention improves the clinical outcomes of OGIB patients. On the contrary, there are no clear guidelines for further investigation of patients with negative CE findings at the present. Although patients in stable general condition may only require follow-up, repeated CE is useful to detect positive findings in patients with evidence of sustained bleeding and progressing anemia. We have revealed that repeated CE has higher positive finding rate than DBE in OGIB patients with negative CE findings in a preliminary study. Key Messages: CE and DBE have complementary roles in the management of OGIB, and the precise timing and proper sequence may be important for the approach to treating OGIB.

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Section: Utility Of Ce In Ogibmentioning

confidence: 99%

Clinical Utility of Capsule Endoscopy and Double-Balloon Enteroscopy in the Management of Obscure Gastrointestinal Bleeding

et al. 2018

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“…25 Seven of them were prospective 15,20,21,28,[33][34][35] and 17 were retrospective studies. [12][13][14][16][17][18][19][22][23][24][25][26][27][29][30][31][32] Only 2 were multicenter studies. 12,13 In all but 4 studies (in 3, not reported 18,23,27 and 1 study 31 with EndoCapsule [Olympus, Tokyo, Japan]), SBCE explorations were performed with capsule endoscopes from Given Imaging Ltd (Yoqneam, Israel).…”

Section: Descriptive Assessment and Study Characteristicsmentioning

confidence: 99%

“…Four publications focused exclusively on IDA patients (subset 1), 21,30,33,35 whereas in the remaining 20 articles, patients with IDA represented only a subgroup of a larger patient cohort undergoing SBCE (subset 2). [12][13][14][15][16][17][18][19][20][22][23][24][25][26][27][28][29]31,32,34 The QUADAS evaluation of the included studies is shown in Table 2. Nine QUADAS items (items 3-11) were not relevant and thus not assessed.…”

Section: Descriptive Assessment and Study Characteristicsmentioning

confidence: 99%

“…Based on the remaining 5 items (items 1, 2, 12-14), the studies included were of low or moderate quality. Nine studies (39%) 12,13,17,20,21,27,30,33,35 provided data on mean or median pre-SBCE hemoglobin (Hb) levels, 11 (43.5%) 12,13,[19][20][21][22]27,30,31,33,35 reported data on mean or median patient age. Where median and interquartile range were given instead of mean and standard deviation, approximation was used.…”

Section: Descriptive Assessment and Study Characteristicsmentioning

confidence: 99%

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Diagnostic yield of small-bowel capsule endoscopy in patients with iron-deficiency anemia: a systematic review

Koulaouzidis

Rondonotti

Giannakou

et al. 2012

Gastrointestinal Endoscopy

112

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“…Angiodysplasias, tumours, Crohn’s disease, intestinal tuberculosis and hookworm infestation were predominant aetiologies. Katsinelos et al [11] assessed the diagnostic yield of capsule endoscopy in 63 patients with obscure GI bleeding and normal upper and lower endoscopy. The overall diagnostic yield was 44.44% of patients and included findings of angiectasia in 11 patients, non-steroidal anti-inflammatory drugs enteropathy in 6 patients, celiac disease in 3 patients, tumours in 2 patients and a variety of other diagnoses ranging from varices to ulcers.…”

Section: Discussionmentioning

confidence: 99%

Single-Photon Emission Computed Tomography Enhanced Tc-99m-Pertechnetate Disodium-Labelled Red Blood Cell Scintigraphy in the Localization of Small Intestine Bleeding: A Single-Centre Twelve-Year Study

Doležal

Vízda²,

Kopáčová³

2011

Digestion

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Aim: To present our experience with the detection of bleeding in the small intestine by means of scintigraphy with in vivo-labelled red blood cells (RBCs) in the period of 1998–2009. Materials and Methods: A 12-year prospective study was accomplished with 40 patients (23 men, 17 women, aged 12–91, mean 56 years) who had lower gastrointestinal bleeding (obscure-overt bleeding) and underwent scintigraphy with in vivo-labelled RBCs by means of technetium 99m. The scintigraphy was usually performed after other diagnostic tests had failed to locate the bleeding. Results: A total of 26 patients had a positive scintigraphy with in vivo-labelled RBCs and 14 patients had negative scintigraphy. The final diagnosis was confirmed in 20 of 26 patients with a positive scintigraphy by push enteroscopy (6/20), intraoperative enteroscopy (7/20), surgery (4/20), duodenoscopy (1/20), double-balloon enteroscopy (1/20) and X-ray angiography (1/20). The correct location of the bleeding site was identified by RBC scintigraphy in 15 of 20 (75%) patients with the confirmed source. The locations of the bleeding site identified by scintigraphy and enteroscopy (push, intraoperative) and surgical investigations were highly correlated in patients with a positive scintigraphy within the first 3 h. Eleven of the 20 correctly localized studies and none of the incorrectly localized studies were positive in the dynamic phase of imaging. In 5 patients (all erroneously localized), scintigraphy was positive only at a period longer than 18 h. Conclusion: RBC scintigraphy is an effective imaging modality in localizing lower gastrointestinal bleeding in patients for whom other diagnostic tests have failed to locate the bleeding. RBC scintigraphy can be successful in the detection of bleeding sites in the small intestine.

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Diagnostic Yield and Clinical Impact of Capsule Endoscopy in Obscure Gastrointestinal Bleeding during Routine Clinical Practice: A Single-Center Experience

Cited by 28 publications

References 42 publications

Clinical Utility of Capsule Endoscopy and Double-Balloon Enteroscopy in the Management of Obscure Gastrointestinal Bleeding

Clinical Utility of Capsule Endoscopy and Double-Balloon Enteroscopy in the Management of Obscure Gastrointestinal Bleeding

Diagnostic yield of small-bowel capsule endoscopy in patients with iron-deficiency anemia: a systematic review

Single-Photon Emission Computed Tomography Enhanced Tc-99m-Pertechnetate Disodium-Labelled Red Blood Cell Scintigraphy in the Localization of Small Intestine Bleeding: A Single-Centre Twelve-Year Study

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