Factors associated with the clinical impact of capsule endoscopy in patients with overt obscure gastrointestinal bleeding

Motohiro Esaki, Takayuki Matsumoto, Shinichiro Yada, Ritsuko Yanaru-Fujisawa, Tetsuji Kudo, Shunichi Yanai, Shotaro Nakamura, Mitsuo Iida

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58 Citations (Scopus)

Abstract

Background and Study Aims: Capsule endoscopy (CE) does not necessarily identify positive findings in patients with overt obscure gastrointestinal bleeding (OGIB). We aimed to identify factors predictive of positive CE findings and those of re-bleeding after negative CE in overt OGIB. Patients and Methods: We retrospectively analyzed 68 patients who underwent CE for overt OGIB. CE findings, therapeutic interventions, and clinical course after CE were reviewed. Clinical variables associated with positive CE findings and those associated with re-bleeding after negative CE findings were investigated. Results: Positive CE finding was found in 36 (53%) patients. Marked decrease in hemoglobin value [OR; 18.8, 95% CI; 3.4-152.0] and earlier CE examination within a week after the last episode of bleeding [OR; 8.0, 95% CI; 2.2-35.9] were factors associated with positive CE findings. Nine (28%) of 32 patients with negative CE findings re-bled. Marked decrease in hemoglobin value was more frequent in patients with re-bleeding than those without (P = 0.07). Conclusion: Patients with massive and overt OGIB are the best candidates for CE. Earlier CE, virtually within a week, contributes to the better diagnostic yield of the procedure. Careful follow-up seems necessary for patients with massive bleeding even in cases of negative CE findings.

Original languageEnglish
Pages (from-to)2294-2301
Number of pages8
JournalDigestive Diseases and Sciences
Volume55
Issue number8
DOIs
Publication statusPublished - Aug 2010

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology

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    Esaki, M., Matsumoto, T., Yada, S., Yanaru-Fujisawa, R., Kudo, T., Yanai, S., Nakamura, S., & Iida, M. (2010). Factors associated with the clinical impact of capsule endoscopy in patients with overt obscure gastrointestinal bleeding. Digestive Diseases and Sciences, 55(8), 2294-2301. https://doi.org/10.1007/s10620-009-1036-5