The American Society for Gastrointestinal Endoscopy (ASGE) diagnostic algorithm for obscure gastrointestinal bleeding: Eight burning questions from everyday clinical practice

Rondonotti, Emanuele; Marmo, Riccardo; Petracchini, Massimo; Franchis, Roberto de; Pennazio, Marco

doi:10.1016/j.dld.2012.07.012

Cited by 58 publications

(39 citation statements)

References 67 publications

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“…On the other hand, a negative VCE exam provides reassurance against the likelihood of re-bleeding since its negative predictive value (NPV) is high, favoring a wait and watch approach (3,14), in the short term. However, data on the long-term outcomes of patients with a negative VCE are scant.…”

Section: Re-bleeding Rate After Index Vce Small Bowel Examinationmentioning

confidence: 99%

“…Nonetheless, VCE will not achieve to detect the bleeding lesion in a sizeable proportion (up to one third) of patients with OGIB; constituting long-term management of those patients a clinical challenge. Several reviews and consensus recommendations support conservative approach when VCE is non-diagnostic and evidence of ongoing bleeding is lacking (3,45). Still, even recent guidelines were not fully based on long-term re-bleeding data (14).…”

Section: Impact On Subsequent Therapeutic Strategies and Clinical Outmentioning

confidence: 99%

“…OGIB can be further categorized into occult and overt bleeding (2). While occult OGIB occurs in the setting of a positive fecal occult blood test (FOBT) or iron deficiency anemia (IDA), overt OGIB is the clinically evident manifestation of GI bleeding as melena or hematochezia (2,3). The advent of video capsule endoscopy (VCE), revolutionized the approach and management of patients with small bowel diseases and particularly with OGIB (4).…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Re-bleeding Rate After Index Vce Small Bowel Examinationmentioning

confidence: 99%

Section: Impact On Subsequent Therapeutic Strategies and Clinical Outmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2017

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“…Nonetheless, several studies demonstrated that the visualization of the small bowel with forward-viewing capsules is suboptimal [1][2][3][6][7][8][9][10][11][12][13][14]. First, the exploration of the entire small bowel can be achieved only in about 80% of patients [1][2][3]6].…”

Section: Introductionmentioning

confidence: 99%

“…First, the exploration of the entire small bowel can be achieved only in about 80% of patients [1][2][3]6]. Furthermore, VCE can miss about 30% of discrete lesions, especially in the proximal segments where passive capsules are rapidly propelled by gut motility [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%