• Periklis Apostolopoulos, Christos Liatsos, Ian M Gralnek, Chrissostomos Kalantzis, Eleftheria Giannakoulopoulou, Georgios Alexandrakis, Panagiotis Tsibouris, Evagelos Kalafatis, and Nikolaos Kalantzis.
• Department of Gastroenterology, Army Share Fund (NIMTS) Hospital, Athens, Greece.
• Gastrointest. Endosc. 2007 Dec 1; 66 (6): 1174-81.

BackgroundThe role of capsule endoscopy (CE) in the diagnosis of active mild-to-moderate GI bleeding (GIB) immediately after a negative EGD and ileocolonoscopy has not been prospectively evaluated.ObjectiveTo estimate the diagnostic yield and clinical significance of CE in patients with acute, obscure, overt, mild-to-moderate GIB.DesignA single-center prospective study.PatientsDuring a 3-year period, 573 patients admitted to the hospital with acute mild-to-moderate GIB were included in this study. Among them, 37 patients (6.5%) with negative endoscopic findings, after urgent upper- and lower-GI endoscopies, underwent CE within the first 48 hours to identify the source of bleeding.ResultsCE revealed active bleeding in 34 patients and a diagnostic yield of 91.9%, including angiodysplasias in 18 patients, ulcers in 3 patients, and tumors in 2 patients. In the remaining 11 patients (32%), CE revealed the site of bleeding: distal duodenum in 1 case (9%), jejunum in 6 cases (54%), ileum in 2 cases (18%), and cecum in 2 cases (18%). From the 37 bleeders, 16 were managed conservatively, 14 endoscopically, and 7 surgically. During a 12-month follow-up period, bleeding recurrence was observed in 5 of 32 (15.6%).LimitationsThis study had a limited number of patients.ConclusionsCE appeared to have a high diagnostic yield in patients with acute, mild-to-moderate, active hemorrhage of obscure origin when performed in the hospital after a negative standard endoscopic evaluation and has important clinical value in guiding medical management.

23 keywords...

hide…