Outcome after enteroscopy for patients with obscure GI bleeding: diagnostic comparison between double-balloon endoscopy and videocapsule endoscopy

Arakawa, Daigo; Ohmiya, Naoki; Nakamura, Masanao; Honda, Wataru; Shirai, Osamu; Itoh, Akihiro; Hirooka, Yoshiki; Niwa, Yasumasa; Maeda, Osamu; Ando, Takafumi; Goto, Hidemi

doi:10.1016/j.gie.2008.06.008

Cited by 172 publications

(177 citation statements)

References 21 publications

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“…Marmo et al [19] reported two missed jejunal diverticula that were later seen on subsequent DBE. Similarly, Arakawa et al [20] reported 2 cases of diverticulosis of the small bowel that were missed at previous VCE. In this larger series, the sensitivity of VCE for detecting diverticula was only 9%, confirming that VCE cannot be relied upon to make this diagnosis.…”

Section: Discussionmentioning

confidence: 95%

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Accuracy of community based video capsule endoscopy in patients undergoing follow up double balloon enteroscopy

Tenembaum

Sison²,

Rubin³

2013

WJGE

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AIM:To determine the test characteristics of community based video capsule endoscopy (VCE) in patients undergoing sequential VCE and double balloon enteroscopy (DBE). METHODS:Eighty-nine patients (34 females, 55 males, mean age 66) who underwent both VCE and DBE from 2008-2010 were retrospectively reviewed. Lesions detected at VCE were categorized. Capsule directed DBE followed and included 44 antegrade, 11 retrograde and 34 combined antegrade and retrograde procedures. Lesions detected were compared utilizing the McNemar's test. RESULTS:Angioectasia detection with VCE was 25% and with DBE 35% (P < 0.03) with a calculated sensitivity and specificity of 58% and 93% respectively. Polyps were detected by VCE in 22% and in DBE 20%, (P = 0.6), with a sensitivity and specificity for VCE of 61% and 87%. Small bowel diverticula were only seen in 1% of VCE but in 12% of DBE patients (P < 0.002) with a calculated sensitivity and specificity of VCE of 9% and 100%.CONCLUSION: VCE would be moderately sensitive and specific overall with considerable variation by lesion. Furthermore, VCE cannot be relied upon to diagnose small bowel diverticula.© 2013 Baishideng. All rights reserved.Key words: Video capsule endoscopy; Double balloon enteroscopy; Angioectasia; Diverticulosis; Obscure gastrointestinal bleeding Core tip: Advances in endoscopic technology have revolutionized the evaluation of small intestinal disorders. Non-invasive imaging utilizing video capsule endoscopy (VCE) offers the potential to safely visualize the entire small bowel with a high diagnostic yield. It is limited by a lack of therapeutic ability, imprecise localization, failure to reach the colon in all cases and inconsistent visualization of the entire small bowel. Deep enteroscopy, utilizing double balloon enteroscopy (DBE), enables diagnostic and therapeutic endoscopy of the small bowel. Although total enteroscopy can be accomplished, it typically requires antegrade and retrograde approaches. In most clinical situations, VCE is performed initially. By using DBE as the criterion (gold) standard, the sensitivity and specificity of community based VCE can be assessed for individual lesions, offering a more informative comparison than diagnostic yield.

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Section: Discussionmentioning

confidence: 95%

“…Similarly, Arakawa reported 3 cases with missed angioectasia at DBE. Both studies attributed the missed lesions to incomplete DBE [18,20] . Angioectasia detected at DBE but not at VCE has also been described.…”

mentioning

confidence: 99%

Accuracy of community based video capsule endoscopy in patients undergoing follow up double balloon enteroscopy

Tenembaum

Sison²,

Rubin³

2013

WJGE

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“…11 Endoscopic diagnostics offer the highest yield to detect small bowel bleeding, and in most situations, CE is done first to detect and characterise the bleeding site or to rule out small bowel bleeding. 12 Being more complex to perform, DBE is reserved for those cases in which therapeutic interventions are needed or biopsies have to be taken. 13 Diagnostic sequence of CE before DBE after negative results from upper and lower endoscopy is a cost-effective approach in a wide range of scenarios depending on probability of need of a therapeutic intervention: In a recent study, the breakeven point at which cost per procedure is equalized for CE versus DBE was reached at 79 procedures p.a.…”

Section: Treatment Of Small Bowel Bleedingmentioning

confidence: 99%

Interventional balloon-enteroscopy

Albert¹

2012

jig

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“…Kameda et al examined diagnostic yield of double-balloon endoscopy (65%) and CE (71%). Although Lin et al supported Kamada, diagnostic yield of double-balloon endoscopy was found to be higher than that of CE in a study conducted by Arakawa et al [12,13] In conclusion, CE is superior method because it is non-invasive, does not require sedation or radiation, and provides better diagnostic value. Although CE offers advantages over other methods, it also has drawbacks, such as inability to perform biopsy or therapeutic intervention, and there is risk for capsule retention.…”

Section: Yes Nomentioning

confidence: 92%

“…Guidelines developed by Gerson et al are presented here as an example. [8][9][10][11][12][13][14][15][16][17][18] Our algorithm is shown in Figure 5.…”

Section: Yes Nomentioning

confidence: 99%

What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?

Üçüncü¹

2016

Ulus Travma Acil Cerrahi Derg

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Outcome after enteroscopy for patients with obscure GI bleeding: diagnostic comparison between double-balloon endoscopy and videocapsule endoscopy

Cited by 172 publications

References 21 publications

Accuracy of community based video capsule endoscopy in patients undergoing follow up double balloon enteroscopy

Accuracy of community based video capsule endoscopy in patients undergoing follow up double balloon enteroscopy

Interventional balloon-enteroscopy

What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?

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