Factors Associated with the Clinical Impact of Capsule Endoscopy in Patients with Overt Obscure Gastrointestinal Bleeding

Esaki, Motohiro; Matsumoto, Takayuki; Yada, Shinichiro; Yanaru-Fujisawa, Ritsuko; Kudo, Toshifumi; Yanai, Shunichi; Nakamura, Shotaro; Iida, Mitsuo

doi:10.1007/s10620-009-1036-5

Cited by 71 publications

(67 citation statements)

References 41 publications

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“…Pennazio et al [16] reported that the diagnostic yield of CE was significantly higher in patients with ongoing overt OGIB (92.3%), intermediate in patients with occult OGIB (44.2%) and lowest in patients with previous overt OGIB (12.9%). In the overt OGIB group, the diagnostic yield was inversely proportional to the length of time since the last bleeding episode, as delay in the use of CE allows for healing of the bleeding site [24] . CE thus has its highest diagnostic yield in patients with ongoing and overt bleeding [16,25] .…”

Section: Capsule Endoscopymentioning

confidence: 99%

Evaluation and outcomes of patients with obscure gastrointestinal bleeding

Santhakumar

Liu

2014

WJGP

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Core tip: This article examines the role of current diagnostic modalities for the investigation of obscure gastrointestinal bleeding (OGIB) and outcomes in patients undergoing these investigations. Capsule endoscopy and double balloon enteroscopy remain the cornerstone of diagnostic and therapeutic management. The diagnostic and therapeutic capabilities of certain modalities are influenced by the nature of bleeding in OGIB. Longterm outcome data in patients with OGIB is limited but is most promising for capsule endoscopy.Santhakumar C, Liu K. Evaluation and outcomes of patients with obscure gastrointestinal bleeding. World J Gastrointest Pathophysiol 2014; 5(4

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Section: Capsule Endoscopymentioning

confidence: 99%

Evaluation and outcomes of patients with obscure gastrointestinal bleeding

Santhakumar

Liu

2014

WJGP

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“…Most published reports on CE in OGIB are limited to small groups of patients [6][7][8] . Although most differentiate between occult and overt GI bleeding when analyzing diagnostic yield, they do not identify the optimum time for performing CE in the overt GI bleeding group.…”

Section: Introductionmentioning

confidence: 99%

Single center experience of capsule endoscopy in patients with obscure gastrointestinal bleeding

Goenka

Majumder²,

Kumar

et al. 2011

WJG

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AIM:To identify optimum timing to maximize diagnostic yield by capsule endoscopy (CE) in patients with obscure gastrointestinal bleeding (OGIB). METHODS:We identified patients who underwent CE at our institution from August 2003 to December 2009. Patient medical records were reviewed to determine type of OGIB (occult, overt), CE results and complications, and timing of CE with respect to onset of bleeding. RESULTS:Out of 385 patients investigated for OGIB, 284 (74%) had some lesion detected by CE. In 222 patients (58%), definite lesions were detected that could unequivocally explain OGIB. Small bowel ulcer/erosions secondary to Crohn's disease, tuberculosis or non-steroidal anti-inflammatory agent use were the commonest lesions detected. Patients with overt GI bleeding for < 48 h before CE had the highest diagnostic yield (87%). This was significantly greater (P < 0.05) compared to that in patients with overt bleeding prior to 48 h (68%), as well as those with occult OGIB (59%). CONCLUSION:We established the importance of early CE in management of OGIB. CE within 48 h of overt bleeding has the greatest potential for lesion detection.

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“…Angiodysplasia was the most common finding among patients with positive VCE (70%) and the majority of them received some mode of treatment leading to bleeding resolution (69%). Esaki et al (51) with positive VCE findings. The reported re-bleeding rate (10.7%) was equivalent to those in previous studies (6-10%), implying that use of anti-coagulation therapy or type of therapy may pose a certain effect.…”

Section: Impact On Subsequent Therapeutic Strategies and Clinical Outmentioning

confidence: 96%

“…This might be linked to the increased prevalence of angiodysplasia among older individuals and the high incidence of angiodysplasia when chronic kidney disease is present (2,64). Documented fall in hemoglobin below 8 g/dL as well as higher need of blood units transfusion prior to VCE mandates clinical reevaluation and pursue of further endoscopic investigations (27,28,30,51,52).…”

Section: Predictive Factors For Re-bleeding After Index Vcementioning

confidence: 99%

Long-term effects of video capsule endoscopy in the management of obscure gastrointestinal bleeding

et al. 2017

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Obscure gastrointestinal bleeding (OGIB) accounts for approximately 5% of all gastrointestinal (GI) hemorrhages. It usually arises from a small bowel lesion beyond the reach of conventional endoscopy including esophagogastroduodenoscopy and colonoscopy. Video capsule endoscopy (VCE) revolutionized the evaluation of OGIB patients since it allows reliable and noninvasive visualization of the small bowel mucosal surface. Since 2001, VCE has evolved into an efficient technology integrated in clinical practice. It is the cornerstone in the algorithm of OGIB investigation given its high diagnostic yield, which compares favorably to that of double-balloon enteroscopy (DBE). In terms of outcomes, a positive index VCE examination usually correlates to a high re-bleeding rate, while a negative one provides adequate evidence of low re-bleeding risk, suggesting a wait and watch approach in this subset of patients. Additionally, a variety of factors has been acknowledged as significant predictors of re-bleeding episodes. While research data regarding immediate endoscopic findings have matured, data concerning the clinical utility of VCE in patients with OGIB on the long-term remain sparse. This manuscript reviews the current literature, aiming to highlight the role of VCE in the long-term management of OGIB.

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Factors Associated with the Clinical Impact of Capsule Endoscopy in Patients with Overt Obscure Gastrointestinal Bleeding

Abstract: Patients with massive and overt OGIB are the best candidates for CE. Earlier CE, virtually within a week, contributes to the better diagnostic yield of the procedure. Careful follow-up seems necessary for patients with massive bleeding even in cases of negative CE findings.

Cited by 71 publications

References 41 publications

Evaluation and outcomes of patients with obscure gastrointestinal bleeding

Evaluation and outcomes of patients with obscure gastrointestinal bleeding

Single center experience of capsule endoscopy in patients with obscure gastrointestinal bleeding

Long-term effects of video capsule endoscopy in the management of obscure gastrointestinal bleeding

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