Background: The most frequent indication For capsule endoscopy is to
diagnose the cause of obscure GI bleeding. The objective of the study
was to determine the impact of capsule endoscopy on the outcome of
patients with GI bleeding of obscure origin.
Methods: Ninety-six patients (53 men, 43 women; mean [standard
deviation] age, 60.84 years [16.55 years]) were enrolled in the study.
All patients have been Subjected to gastroscopy colonoscopy, small-bowel
barium follow-through or enteroclysis, and push enteroscopy; no bleeding
site had been identified. Capsule endoscopy was performed with the Given
M2A video capsule system. By using strict criteria, studies were
classified as having positive findings, findings of uncertain
significance, and no findings. Outcome was defined as continued or
complete resolution of bleeding.
Results: Positive findings, findings of uncertain significance, and no
findings were identified in 41.7%, 20.8%, and 37.5% of our Study
population, respectively The most common lesions seen were
angiodysplasias of the small intestine. Therapeutic intervention was
possible in 82.5% of patients with positive findings and in 35.0% of
patients with findings of uncertain significance. Complete resolution of
bleeding, after a median (interquartile range) follow-up period of 14
months (9-17 months), occurred significantly more often in patients with
positive findings (68.4%) compared with patients with findings of
uncertain significance and no findings (40.8%, P = 0.009).
Conclusions: Capsule endoscopy increases the diagnostic yield in the
workup of patients with obscure small-bowel bleeding. Strictly defined
positive findings are associated with a favorable outcome
