Very High Yield of Urgent Small-Bowel Capsule Endoscopy for Ongoing Overt Suspected Small-Bowel Bleeding Irrespective of the Usual Predictive Factors

Abstract

Evidence for an urgent approach to ongoing overt suspected small-bowel bleeding (SSBB) is scarce. We aimed to analyze our series of urgent small-bowel capsule endoscopies (SBCEs) for ongoing overt SSBB and to identify factors associated with positive findings and outcomes. A retrospective study of all SBCEs performed in the first 48 h after admission for overt SSBB between January 2006 and February 2022 was performed. Descriptive and inferential analyses (univariate and multivariable) were performed. Eighty-three urgent SBCEs were performed for overt SSBB. Patients were mostly men (69.2%, median age 68) and were followed for a median of 58.2 months (range 5–176). The diagnostic yield was 80.7%; in 60.2%, blood was detected in the small bowel (SB), while in 50.6%, a bleeding lesion was identified, mostly angioectasia. Patients with diabetes mellitus or taking NSAIDs were more prone to present SB findings, yet the explanatory power was low. Endoscopic or surgical treatments were performed in 28.9% and 19.3%, respectively, with the “non-conservative” therapeutic yield being 56.6%. Rebleeding occurred in 20.5% and was associated in the multivariable analysis with the female gender and anticoagulants use. This cohort of urgent SBCE, the largest from a European center, reinforces the usefulness of SBCE for ongoing overt SSBB management. This prompt performance of this procedure is highly effective, regardless of patients’ features.

Capsule Enteroscopy Using the Mirocam® versus OMOM® Systems: A Matched Case–Control Study

“…Regarding small bowel preparation, we only found significant differences in the segmental analysis (per tertile), with the scores obtained from the OMOM ® HD group always being superior ( p < 0.05). Considering that cases and controls followed the same preparation protocol (clear liquids on the previous day plus 4 L of KleanPrep) and were matched for factors known to impact bowel preparation (such as age and comorbidities [ 18 ]), it may be hypothesized that the differences are related to the characteristics of the device retrieving the images. Indeed, advanced optics may influence small bowel mucosal visualization [ 18 ].…”

“…Considering that cases and controls followed the same preparation protocol (clear liquids on the previous day plus 4 L of KleanPrep) and were matched for factors known to impact bowel preparation (such as age and comorbidities [ 18 ]), it may be hypothesized that the differences are related to the characteristics of the device retrieving the images. Indeed, advanced optics may influence small bowel mucosal visualization [ 18 ]. In comparison to Mirocam ® MC1600, the OMOM ® HD system has a similar angle of view (172° versus 170°), fewer LED lights (four versus six), but a higher resolution (512 × 512 versus 320 × 320 pixels).…”