Emergency Physicians Accurately Interpret Video Capsule Endoscopy Findings in Suspected Upper Gastrointestinal Hemorrhage: A Video Survey

Meltzer, Andrew C.; Pinchbeck, Carrie; Burnett, Sarah; Buhumaid, Rasha; Shah, Payal; Ding, Ru; Fleischer, David E.; Gralnek, Ian M.

doi:10.1111/acem.12165

Cited by 20 publications

(11 citation statements)

References 21 publications

(31 reference statements)

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“…Training of ER physicians to interpret VCE images has also been found to be feasible in a survey study involving 126 emergency department physicians. 91 There are concerns about the costs of VCE used in such circumstances, but a cost-effectiveness analysis comparing VCE with other strategies for managing UGIB showed that VCE was cost-effective for patients at low and moderate risk presenting to the ER with UGIB. 92 …”

Section: Consensus Statementsmentioning

confidence: 99%

Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018

Sung

Chiu

Chan

et al. 2018

Gut

212

210

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Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the ’gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages. These include pre-endoscopy risk stratification scores, blood and platelet transfusion, use of proton pump inhibitors; during endoscopy new haemostasis techniques (haemostatic powder spray and over-the-scope clips); and post-endoscopy management by second-look endoscopy and medication strategies. Emerging techniques, including capsule endoscopy and Doppler endoscopic probe in assessing adequacy of endoscopic therapy, and the pre-emptive use of angiographic embolisation, are attracting new attention. An emerging problem is the increasing use of dual antiplatelet agents and direct oral anticoagulants in patients with cardiac and cerebrovascular diseases. Guidelines on the discontinuation and then resumption of these agents in patients presenting with NVUGIB are very much needed. The Asia-Pacific Working Group examined recent evidence and recommends practical management guidelines in this updated consensus statement.

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Section: Consensus Statementsmentioning

confidence: 99%

Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018

Sung

Chiu

Chan

et al. 2018

Gut

212

210

View full text Add to dashboard Cite

show abstract

“…Poor visualisation of the duodenum due to the lapsed battery life of PillCam Eso was a major factor in lack of concordance between CE and OGD findings; this could potentially be addressed in newer generation capsules. ED physicians appeared to be competent to use the system after a brief training period [22]. Initial cost analyses appear favourable although further studies are required to validate this [20].…”

Section: Upper Gi Bleedingmentioning

confidence: 91%

Future Development of Capsule Endoscopy

Hale

McAlindon

2014

Handbook of Capsule Endoscopy

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“…Given the lack of reliable noninvasive diagnostic tools, the indication for emergency endoscopy is generally based on clinical parameters 2 3 4 . Novel tools that can determine presence or absence of severe bleeding may aid urgent triage and also save resources by avoiding unnecessary emergency endoscopies 5 . We present a prospective pilot trial, which aimed to evaluate feasibility and safety of detection of acute UGIB using a novel telemetric sensor capsule.…”

Section: Introductionmentioning

confidence: 99%

Novel telemetric sensor capsule for EGD urgency triage: a feasibility study

et al. 2019

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Background and study aims Upper gastrointestinal bleeding (UGIB) is a frequent cause of hospitalization. Because of the lack of reliable noninvasive diagnostic tools, the decision to proceed with emergency endoscopy in these cases is made based on clinical parameters. A novel non-imaging telemetric real-time sensor capsule (HemoPill Acute, Ovesco Endoscopy AG) has shown promising results for noninvasive detection of UGIB in preclinical studies. Patients and methods We conducted a prospective non-randomized, single center, open-label study to investigate feasibility and safety of the novel sensor capsule in patients with symptoms of UGIB. The primary aim of the first clinical study was to investigate feasibility and safety of the device in a clinical setting. All patients underwent endoscopy within 12 hours after capsule ingestion. Sensor data from the capsule within 10 minutes after ingestion were compared with endoscopic findings. Results From April 2015 to February 2016, 30 consecutive patients with symptoms of acute UGIB were included; 27 were eligible for analysis. Capsule ingestion was well tolerated in all patients and there were no device-related adverse events. Endoscopy showed blood or hematin in the upper gastrointestinal tract of 10 of 27 patients; in 2 of 10 patients it was estimated to be more than 20 mL; in 4 of 8 patients it was between 5 and 20 mL and in 4 of 8 it was estimated to < 5 mL. The sensor capsule was positive in 2 of 2 patients (100 %) with > 20 mL of blood or hematin and in 1 of 8 patients (12.5 %) between 5 and 20 mL. All patients (17/17; 100 %) were correctly identified as non-bleeders. Conclusion Both device and procedure proved to be safe and feasible. Larger studies will be necessary to evaluate the role of the sensor capsule in risk stratification of patients with acute UGIB.

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Emergency Physicians Accurately Interpret Video Capsule Endoscopy Findings in Suspected Upper Gastrointestinal Hemorrhage: A Video Survey

Cited by 20 publications

References 21 publications

Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018

Asia-Pacific working group consensus on non-variceal upper gastrointestinal bleeding: an update 2018

Future Development of Capsule Endoscopy

Novel telemetric sensor capsule for EGD urgency triage: a feasibility study

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