Second capsule endoscopy for patients with severe iron deficiency anemia

Bar‐Meir, Simon; Eliakim, Rami; Nadler, Moshe; Barkay, Olga; Fireman, Zvi; Scapa, Eitan; Chowers, Yehuda; Bardan, Eytan

doi:10.1016/s0016-5107(04)02051-6

Cited by 62 publications

(34 citation statements)

References 11 publications

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“…Thus, specialized hospital units should act as a filter for referring physicians' requests for capsule endoscopy in the absence of validated management guidelines because it is an expensive and time-consuming diagnostic tool. Other authors have recommended a second CE for some patients with iron deficiency anemia [15], based on the fact that lesions within the range of examination with a standard upper endoscope may be overlooked, it can also happen with CE. Although it seems logical, it is reasonable to improve the diagnostic workup in such patients, ideally performed by experienced endoscopists.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Yield and Impact of Capsule Endoscopy on Management of Patients with Gastrointestinal Bleeding of Obscure Origin

Redondo–Cerezo¹,

Pérez-Vigara²,

Pérez-Sola³

et al. 2007

Dig Dis Sci

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This study assessed diagnostic yield and impact of capsule endoscopy on patient management. Seventy-five patients with obscure gastrointestinal bleeding were included. Clinical and followup information was collected by review of patient records and with personal contact with the referring physicians. All previous clinical information and interventions after capsule endoscopy and clinical outcome were noted. The indication was obscure-overt gastrointestinal bleeding in 36 patients (48%) and obscure-occult gastrointestinal bleeding in 39 patients (52%). Overall diagnostic yield was 66.7% considering relevant lesions. Followup was available in 31 patients. Capsule endoscopy changed clinical management in 61.4%. Multivariate analysis showed that patients with another potential source of bleeding and patients whose onset was hematochezia were not good candidates for capsule endoscopy. Capsule endoscopy has a high diagnostic yield and a positive influence on clinical management in a high proportion of patients with obscure gastrointestinal bleeding.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Yield and Impact of Capsule Endoscopy on Management of Patients with Gastrointestinal Bleeding of Obscure Origin

Redondo–Cerezo¹,

Pérez-Vigara²,

Pérez-Sola³

et al. 2007

Dig Dis Sci

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“…On the other hand, there are some reports that repeated CE was beneficial due to its high diagnostic yield. Bar-Meir et al [29] revealed that 20% of patients with severe iron-deficiency anemia in whom the first CE was negative had positive findings on repeated CE. Viazis et al [30] suggested that patients with negative CE findings would benefit from repeated CE if the hemoglobin level dropped to ≥4 g/dL.…”

Section: Management Of Negative Ce Findingsmentioning

confidence: 99%

Clinical Utility of Capsule Endoscopy and Double-Balloon Enteroscopy in the Management of Obscure Gastrointestinal Bleeding

et al. 2018

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Background: Obscure gastrointestinal bleeding (OGIB) is a common but embarrassing problem for gastroenterologists. Most bleeding lesions associated with OGIB are present in the small intestine and sometimes cannot be identified due to the difficulty associated with physical accessibility. Capsule endoscopy (CE) and double-balloon enteroscopy (DBE) have enabled in the process of diagnosing and have evolved to become approaches to treating OGIB. Summary: CE is a minimally invasive procedure and has a high diagnostic yield in patients with OGIB. DBE offers additional advantage of biopsy collection for pathological diagnosis and therapeutic intervention, but it should be noted that it sometimes causes severe adverse events such as acute pancreatitis, intestinal bleeding, and intestinal perforation. CE should be performed early in the workup course of OGIB. Positive CE findings enhance the diagnostic yield of subsequent DBE, and the effective therapeutic intervention improves the clinical outcomes of OGIB patients. On the contrary, there are no clear guidelines for further investigation of patients with negative CE findings at the present. Although patients in stable general condition may only require follow-up, repeated CE is useful to detect positive findings in patients with evidence of sustained bleeding and progressing anemia. We have revealed that repeated CE has higher positive finding rate than DBE in OGIB patients with negative CE findings in a preliminary study. Key Messages: CE and DBE have complementary roles in the management of OGIB, and the precise timing and proper sequence may be important for the approach to treating OGIB.

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“…In some studies, authors showed that second capsule endoscopy may pick-up some of the lesions missed by first study. [28], [29] Other diseases of small bowel in which capsule endoscopy is indicated are summarized in Table 1. However, capsule endoscopy done in some of these conditions has limitations.…”

Section: Small Bowel Capsule Endoscopy: the Methodsmentioning

confidence: 99%

Capsule Endoscopy: A New Era of Gastrointestinal Endoscopy

Ghoshal¹

2013

Endoscopy of GI Tract

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Second capsule endoscopy for patients with severe iron deficiency anemia

Cited by 62 publications

References 11 publications

Diagnostic Yield and Impact of Capsule Endoscopy on Management of Patients with Gastrointestinal Bleeding of Obscure Origin

Diagnostic Yield and Impact of Capsule Endoscopy on Management of Patients with Gastrointestinal Bleeding of Obscure Origin

Clinical Utility of Capsule Endoscopy and Double-Balloon Enteroscopy in the Management of Obscure Gastrointestinal Bleeding

Capsule Endoscopy: A New Era of Gastrointestinal Endoscopy

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