Outcome in obscure gastrointestinal bleeding after capsule endoscopy

Cañas-Ventura, A.; Marquez, Lucía; Bessa, Xavier; Dedéu, Josep Maria; Puigvehí, Marc; Delgado-Aros, Sílvia; Ibáñez, Inés; Seoane, Agustín; Barranco, Luis; Bory, Felipe; Andreu, Montserrat; González-Suárez, Begoña

doi:10.4253/wjge.v5.i11.551

Cited by 21 publications

(22 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, we did not find a significant difference in the diagnostic yield of CE between the obscure‐overt bleeding and obscure‐occult bleeding groups, which is consistent with the studies by Cañas‐Ventura et al . and Hindryckx et al . Unfortunately, we could not collect data on the duration of overt bleeding before CE.…”

Section: Discussionsupporting

confidence: 91%

Long‐term outcome in patients with obscure gastrointestinal bleeding after capsule endoscopy

Tan

Gao

et al. 2015

J of Digest Diseases

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 91%

Long‐term outcome in patients with obscure gastrointestinal bleeding after capsule endoscopy

Tan

Gao

et al. 2015

J of Digest Diseases

View full text Add to dashboard Cite

show abstract

“…[5,6,11] For instance, EGD is reported to correctly diagnose Dieulafoy’s lesion in 70% of patients, or the overall diagnostic yield of video capsule endoscopy in obscure GIB is reported to be 58%. [12-13] However, because the source of bleeding is rarely known beforehand, such information is of little help in predicting the expected length and characteristics of true GIB workups. Moreover, the existing data are biased by retrograde stratification according to the diagnostic outcome of the endoscopic workup.…”

Section: Discussionmentioning

confidence: 99%

Length of endoscopic workup in gastrointestinal bleeding

Woodward

Williams²,

Sonnenberg³

2016

European Journal of Gastroenterology &Amp; Hepatology

View full text Add to dashboard Cite

Background The number of procedures utilized in the general management of gastrointestinal bleeding (GIB) has not been previously investigated. We used the National Endoscopic Database of the Clinical Outcomes Research Initiative (CORI) for an observational study to analyze the average length of workup in GIB. Methods The electronic database was queried for all patients aged 18 years and older who underwent endoscopic evaluation for any bleeding indication between 2000 and 2014. Data were stratified by indication, type and number of endoscopies per patient, and length of workup. Results A total of 603,807 endoscopic procedures among 451,470 individual patients were used in the workup of GIB, with 152,337 procedures among 113,030 patients (25%) being performed as secondary procedure. The average length was 2.4±0.9 procedures per workup in procedural sequences involving multiple endoscopies. The length of workup was independent of the initial type of GIB. An EGD followed by a colonoscopy or a colonoscopy followed by an EGD were the most frequent combinations. In another substantial fraction of two consecutive procedures, the first and the second procedure were of identical type. This pattern applied not only to EGD and colonoscopy, but also to flexible sigmoidoscopy, enteroscopy, and video capsule endoscopy. Conclusion The majority of patients with GIB require only one type of endoscopy to manage their bleeding. However, in a quarter of patients, on average 2.4 procedures are needed. Previous trials assessing the outcomes of individual types of endoscopy may have exaggerated their overall success rates in diagnosing and treating GIB.

show abstract

“…However, no difference between the VCE-positive (33/55, 60.0%) and VCE-negative group (28/37, 75.7%) was noted regarding condition outcome. Finally, in a recent retrospective study, VCE was associated with a favorable outcome in the majority of patients (52). Surprisingly, treatment application did not correlate with a higher (20.5% vs. 36.4%, P=0.8) resolution re-bleeding rate after specific or nonspecific treatment, respectively; signaling the potential role of angiodysplasia-the most commonly encountered finding-in re-bleeding risk.…”

Section: Impact On Subsequent Therapeutic Strategies and Clinical Outmentioning

confidence: 99%

“…Physicians should also maintain a high level of suspicion in case of older patients since data converge to the conclusion that advanced age is a an independent factor for re-bleeding (27,28,31,52,63). 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).…”

Section: Predictive Factors For Re-bleeding After Index Vcementioning

confidence: 99%

“…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%

See 1 more Smart Citation

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

et al. 2017

View full text Add to dashboard Cite

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.

show abstract

Outcome in obscure gastrointestinal bleeding after capsule endoscopy

Abstract: One third of the patients presented with rebleeding after CE; risk factors were hemoglobin levels < 8 g/dL, age ≥ 70 years or the presence of significant lesions.

Cited by 21 publications

References 29 publications

Long‐term outcome in patients with obscure gastrointestinal bleeding after capsule endoscopy

Long‐term outcome in patients with obscure gastrointestinal bleeding after capsule endoscopy

Length of endoscopic workup in gastrointestinal bleeding

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

Contact Info

Product

Resources

About