The role of capsule endoscopy in acute gastrointestinal bleeding

Nadler, Moshe; Eliakim, Rami

doi:10.1177/1756283x13504727

Cited by 21 publications

(15 citation statements)

References 33 publications

(33 reference statements)

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“…(3) The exact prevalence of angioectasias is unclear because most patients are asymptomatic and only 10% of all patients will experience a symptomatic gastrointestinal bleed during their lifetime (13,17,18). (5,7,11) The clinical presentation of angioectasias includes overt bleeding or iron deficiency anemia, which represent the main indications for endoscopic treatment (3,13,19,20). (5,10) Nevertheless, recurrence rates after medical, endoscopic and/or surgical therapy of SBVL remain unclear (10,13).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that the source of the bleed responsible for OGIB is usually located in the small bowel (2,4). Possible small bowel etiologies of OGIB include angioectasias, erosions and ulcers secondary to Crohn's disease or non-steroidal anti-inflammatory drug use, polyps, tumors, Meckel's diverticulum, varices and Dieulafoy's lesions (5)(6)(7)(8). In Western countries, angioectasias represents the most frequent lesion found during device assisted-enteroscopy (DAE) in patients with OGIB, which is the main indication for this technique (6,(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

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High short-term rebleeding rate in patients undergoing a second endoscopic therapy for small-bowel angioectasias after recurrent bleeding

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High short-term rebleeding rate in patients undergoing a second endoscopic therapy for small-bowel angioectasias after recurrent bleeding

et al. 2017

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“…According to previous research, CE accounts for 56%-70% of small intestinal bleeding disorders [1] , whereas the definite diagnostic yield is only 20%-30% [2,3] . DBE accounts for 60%-70% of the diagnostic yield for intestinal diseases [4,5] .…”

Section: Discussionmentioning

confidence: 99%

Different roles of capsule endoscopy and double-balloon enteroscopy in obscure small intestinal diseases

Zhang¹,

Chun-hua²,

Li³

2015

WJG

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AIM:To compare the roles of capsule endoscopy (CE) and double-balloon enteroscopy (DBE) in the diagnosis of obscure small bowel diseases. December 2014, 88 patients were included in this study; the patients had undergone gastroscopy, colonoscopy, radiological small intestinal barium meal, abdominal computed tomography or magnetic resonance imaging scan and mesenteric angiography, but their diagnoses were still unclear. The patients with gastrointestinal obstructions, fistulas, strictures, or cardiac pacemakers, as well as pregnant women, and individuals who could not accept the capsule-retention or capsule-removal surgery were excluded. Patients with heart, lung and other vital organ failure diseases were also excluded. Everyone involved in this study had undergone CE and DBE. The results were divided into: (1) the definite diagnosis (the diagnosis was confirmed at least by one of the biopsy, surgery, pathology or the drug treatment effects with follow-up for at least 3 mo); (2) the possible diagnosis (a possible diagnosis was suggested by CE or DBE, but not confirmed by the biopsy, surgery or follow-up drug treatment effects); and (3) the unclear diagnosis (no exact causes were provided by CE and DBE for the disease). The detection rate and the diagnostic yield of the two methods were compared. in the etiologies between CE and DBE was estimated, and the different possible etiologies caused by the age groups were also investigated. METHODS: From June 2009 toRESULTS: CE exhibited a better trend than DBE for diagnosing scattered small ulcers (P = 0.242, Fisher' s test), and small vascular malformations (χ 2 = 1.810, P = 0.179, Pearson χ 2 test), but with no significant differences, possible due to few cases. However, DBE was better than CE for larger tumors (P = 0.018, Fisher's test) and for diverticular lesions with bleeding ulcers (P = 0.005, Fisher's test). All three hemangioma cases diagnosed by DBE in this study (including sponge hemangioma, venous hemangioma, and hemangioma with hamartoma lesions) were all confirmed by biopsy. Two parasite cases were found by CE, but were negative by DBE. This study revealed no obvious differences in the detection rates (DR) of CE (60.0%, 53/88) and DBE (59.1%, 52/88). However, the etiological diagnostic yield (DY) difference was apparent. The CE diagnostic yield was 42.0% (37/88), and the DBE diagnostic yield was 51.1% (45/88). Furthermore, there were differences among the age groups (χ 2 = 22.146, P = 0.008, Kruskal Wallis Test). Small intestinal cancer (5/6 cases), vascular malformations (22/29 cases), and active bleeding (3/4 cases) appeared more commonly in the patients over 50 years old, but diverticula with bleeding ulcers were usually found in the 15-25-year group (4/7cases). The over-25-year group accounted for the stromal tumors (10/12 cases).CONCLUSION: CE and DBE each have their own advantages and disadvantages. The appropriate choice depends on the patient's age, tolerance, and clinical manifestations. Sometimes CE followed by DBE is necessary. Core t...

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“…7 9 88-90 Thrombin injection has been described for gastric variceal bleeding in cohort studies, but to date no RCTs have compared it with other treatments. [91][92][93] Post-endoscopic management PPI therapy A meta-analysis of RCTs comparing PPIs to placebo or no therapy in high risk patients undergoing successful endoscopic therapy showed that high dose PPIs, usually given as an intravenous bolus of 80 mg followed by continuous infusion at 8 mg/h for 72 After resuscitation, transfusion to hemoglobin 70-80 g/L, and correction of coagulopathy, endoscopy was undertaken. (B) Through-the-scope clips were applied after dilute epinephrine was injected into the four quadrants of the ulcer base.…”

Section: Endoscopic Therapy Non-variceal Bleedingmentioning

confidence: 99%

Management of acute upper gastrointestinal bleeding

Smith

2018

Clinical Pharmacist

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summarizing evidence for risk assessment, resuscitation, blood transfusion, medical and endoscopic therapy, and early post-endoscopic management. We will not review interventions for long term secondary prevention of bleeding, such as testing for and treating Helicobacter pylori infection, use of non-steroidal anti-inflammatory drugs (NSAIDs), or maintenance antisecretory therapy. Upper gastrointestinal bleeding is managed by many clinicians across many specialties, including emergency room physicians, hospitalists, internists, gastroenterologists, surgeons, interventional radiologists, and hematologists. A variety of topics-including risk assessment, the threshold for blood transfusion, the timing of endoscopy, and medical and endoscopic therapies-have continued to evolve in recent years. In addition, it has become increasingly important and complex to determine the appropriate management of patients who need antithrombotic agents, with gastroenterological, cardiovascular, and hematological aspects needing to be considered. This article provides a comprehensive and evidence based summary of the assessment and management of patients with acute upper gastrointestinal bleeding, which is relevant to clinician specialists, academics, and clinical researchers. A summary of management is provided in the box.

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The role of capsule endoscopy in acute gastrointestinal bleeding

Cited by 21 publications

References 33 publications

High short-term rebleeding rate in patients undergoing a second endoscopic therapy for small-bowel angioectasias after recurrent bleeding

High short-term rebleeding rate in patients undergoing a second endoscopic therapy for small-bowel angioectasias after recurrent bleeding

Different roles of capsule endoscopy and double-balloon enteroscopy in obscure small intestinal diseases

Management of acute upper gastrointestinal bleeding

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