What is the impact of capsule endoscopy in the long term period?

Örmeci, Aslı; Akyüz, Filiz; Baran, Bülent; Göktürk, Suut; Örmeci̇, Tuǧrul; Pınarbaşı, Binnur; Soyer, Özlem Mutluay; Evirgen, Sami; Akyüz, Ümit; Karaca, Çetin; Demır, Kadir; Kaymakoğlu, Sabahattin; Beşışık, Fatih

doi:10.4253/wjge.v8.i7.344

Cited by 13 publications

(6 citation statements)

References 22 publications

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“…A negative SBCE finding was associated with a low risk of recurrent bleeding, and a significant abnormal finding was an independent predictor of recurrent bleeding. (HR = 2.4, 95% CI, 1.1-5.8) [99,100]. Further, although SBCE showed negative findings related to OGIB, it detected other digestive lesions and had an indirect clinical impact [101].…”

Section: Clinical Impactmentioning

confidence: 99%

Diagnostic Yields and Clinical Impacts of Capsule Endoscopy

2021

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Observing the entire small bowel is difficult due to the presence of complex loops and a long length. Capsule endoscopy (CE) provides a noninvasive and patient-friendly method for visualizing the small bowel and colon. Small bowel capsule endoscopy (SBCE) has a critical role in the diagnosis of small bowel disorders through the direct observation of the entire small bowel mucosa and is becoming the primary diagnostic tool for small bowel diseases. Recently, colon capsule endoscopy (CCE) was also considered safe and feasible for obtaining sufficient colonic images in patients with incomplete colonoscopy, in the absence of bowel obstruction. This review article assesses the current status of CE in terms of the diagnostic yield and the clinical impact of SBCE in patients with obscure gastrointestinal bleeding, who have known or suspected Crohn’s disease, small bowel tumor and inherited polyposis syndrome, celiac disease, and those who have undergone CCE.

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Section: Clinical Impactmentioning

confidence: 99%

Diagnostic Yields and Clinical Impacts of Capsule Endoscopy

2021

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“…Obscure gastrointestinal bleeding is defined as a recurrent or persistent bleeding after negative evaluation with upper endoscopy and colonoscopy 2. It accounts for approximately 5% of gastrointestinal (GI) bleeding and in more than 80% of cases, the bleeding arises from small bowel distal to the ampulla of Vater and proximal to the ileocaecal valve 3…”

Section: Differential Diagnosismentioning

confidence: 99%

Arterioportal fistula after partial gastrectomy treated with coil embolisation

2019

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Arterioportal fistulas are a rare complication of abdominal interventions. They can remain asymptomatic for a long time and manifest with symptoms of portal hypertension. We present the case of a 65-year-old man admitted to the emergency room with increasing fatigue and melena. He had a history of partial gastrectomy with Billroth II reconstruction 40 years earlier for peptic ulcer perforation. On physical examination, he was pale and presented a machinery-type murmur in the epigastric area. Blood tests revealed iron deficiency anaemia of 5.6 g/dL. During hospitalisation, he required several blood transfusions and maintained melenas. An abdominal CT angiography showed a fusiform aneurysm of the left gastric artery draining to the venous portal-splenic confluent. He was successfully treated with transarterial coil embolisation of the left gastric artery aneurysm. The correct diagnosis of arterioportal fistulas can be very challenging, whereas the standard treatment with coil embolisation offers a low morbidity resolution of symptoms.

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“…Since previous studies [6, 7] showed a good prognosis and low risk of re-bleeding, a conservative approach is favored in the short-term. However, this strategy is not universally accepted because, data on the re-bleeding rates among patients in the long-term with a negative CE showed results that varied from 4.8 to 36% [7–14]. Undoubtedly, the limitations of CE included missing significant lesions and the inability to provide therapy.…”

Section: Introductionmentioning

confidence: 99%

Re-bleeding and its predictors after capsule endoscopy in patients with obscure gastrointestinal bleeding in long-term follow-up

et al. 2019

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BackgroundCapsule endoscopy (CE) is the preferred diagnostic test of choice in the investigation of obscure gastrointestinal bleeding (OGIB). Although, a conservative strategy is recommended in the short-term, for cases with a negative result from CE, the impact of CE on long-term re-bleeding still remains unclear. Hence, the aim of this study was to determine the long-term re-bleeding rate along with predictors after CE in patients with OGIB.MethodsWe retrospectively reviewed 216 patients with OGIB, whom had received a CE examination, so as to investigate the cause of obscure GI bleeding; between July 2008 and March 2018. The patient’s characteristics, medication use, CE finding, treatments strategy, re-bleeding episodes and follow-up information were collected from the institutional electronic medical chart and CE database. Re-bleeding free survival was evaluated using Kaplan-Meier curves with log rank test, whilst predictors associated with the re-bleeding episodes were analyzed via the use of Cox proportional hazard model.ResultsOne hundred and thirty-three patients with OGIB, having received CE were enrolled in the analysis. The pool rate of re-bleeding was 26.3% (35/133) during a follow-up duration of 26 months after CE. Patients with positive CE study, without specific treatment, had higher rates of re-bleeding (47.6%) than those with positive study whom received specific treatment (25.7%), and negative study (20.8%) (p = 0.042). Although, the re-bleeding free survival was not significantly different among the groups (log rank test; P = 0.10). Re-bleeding events occurring within 6, 12, and 24 months after CE were 36, 64 and 92%, respectively. The high-frequency re-bleeding etiologies were the small bowel angiodysplasias and abnormal vascular lesions. Furthermore, independent predictors for re-bleeding after CE were patients with cirrhosis (hazard ratio, HR 4.06), incomplete CE visualization (HR 2.97), and a history of previous GI bleeding (HR 2.80).ConclusionsThe likelihood of re-bleeding after CE was higher in patients with positive CE study than those with negative study. Specific treatments, or therapeutic interventions for patients with detectable lesions reduced the probability of re-bleeding episodes in long-term follow-up. Close follow-up for recurrent bleeding is recommeded for at least 2 years after CE.

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What is the impact of capsule endoscopy in the long term period?

Abstract: CE is a reliable method in the diagnosis of obscure GI bleeding. Negative CE correlated with a significantly lower rebleeding risk in the long-term follow-up period.

Cited by 13 publications

References 22 publications

Diagnostic Yields and Clinical Impacts of Capsule Endoscopy

Diagnostic Yields and Clinical Impacts of Capsule Endoscopy

Arterioportal fistula after partial gastrectomy treated with coil embolisation

Re-bleeding and its predictors after capsule endoscopy in patients with obscure gastrointestinal bleeding in long-term follow-up

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