Emergency video capsule endoscopy in patients with acute severe GI bleeding and negative upper endoscopy results

Use of capsule endoscopy in the emergency department as a triage of patients with GI bleeding

“…8 This is the first randomized study to show that CE can be used safely to identify which patients presenting with symptoms suggestive of UGIB are high-risk individuals requiring hospital admission. It is safe in the sense that swallowing the capsule endoscope in these patients did not create any problems or adverse events.…”

Endoscopic ultrasonography and small‐bowel endoscopy: Present and future

“…Second, CE is a widespread, well‐tolerated diagnostic tool that perfectly fits with the need for a timely on‐demand SB assessment even in an emergency setting and at the patient's bedside . Notably, the diagnostic yield of enteroscopy decreases substantially with time.…”

“…Very recently, three different studies (one prospective from Germany, one retrospective from Scotland, one prospective RCT from the USA) have raised the debate on the early use of CE in non‐hematemesis GI bleeding. Two of them have shown that CE carried out soon after negative upper endoscopy allows for immediate detection of the bleeding site. In the third study, Marya et al .…”

“…[137][138][139][140][141] Second, CE is a widespread, well-tolerated diagnostic tool that perfectly fits with the need for a timely on-demand SB assessment even in an emergency setting and at the patient's bedside. [141][142][143][144] Notably, the diagnostic yield of enteroscopy decreases substantially with time. In a milestone study published in 2004, the diagnostic yield of CE was 92% for patients with overt bleeding, 44% for occult bleeders, 67% for patients with prior overt bleeding who had been studied within 1-2 weeks, and 33% at 3-4 weeks.…”

“…[133][134][135][136]153,154 Initial DAE can be considered in selected hemodynamically stable patients in cases of massive hemorrhage, when the endoscopic target has already been identified by cross-sectional imaging, or when CE is contraindicated. [133][134][135][136] Very recently, three different studies (one prospective from Germany, 144 one retrospective from Scotland, 143 one prospective RCT from the USA 142 ) have raised the debate on the early use of CE in non-hematemesis GI bleeding. Two of them 143,144 have shown that CE carried out soon after negative upper endoscopy allows for immediate detection of the bleeding site.…”