PTU-013 Do we over estimate the risks of capsule endoscopy in suspected or established small bowel Crohn's disease? A comparison with completion rates and complications observed in the setting of obscure gastrointestinal bleeding

Gut ◽  
2010 ◽  
Vol 59 (Suppl 1) ◽  
pp. A53.2-A53
Author(s):  
J C Macdonald ◽  
V Porter ◽  
B Mackie ◽  
D McNamara
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Obscure Gastrointestinal Bleeding ◽  
Completion Rates

scholarly journals Current Clinical Indications for Small Bowel Capsule Endoscopy

2015 ◽  
Vol 28 (5) ◽  
pp. 632 ◽  
Author(s):  
Bruno Rosa ◽  
José Cotter
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Diagnostic Instrument ◽  
Obscure Gastrointestinal Bleeding ◽  
Disease Extent ◽  
Small Bowel Tumors

<p><strong>Introduction:</strong> Small bowel capsule endoscopy is currently the first line diagnostic examination for many diseases affecting the small bowel. This article aims to review and critically address the current indications of small bowel capsule endoscopy in clinical practice.<br /><strong>Material and Methods:</strong> Bibliographic review of relevant and recent papers indexed in PubMed.<br /><strong>Results and Discussion:</strong> Small bowel capsule endoscopy enables a non-invasive full-assessment of the small bowel mucosa, with high diagnostic yield even for subtle lesions. In patients with obscure gastrointestinal bleeding, diagnostic yield is higher when performed early after the onset of bleeding. Endoscopic treatment of angioectasias using balloon-assisted enteroscopy may contribute to reduce rebleeding, while the risk of rebleeding in patients with “negative“ small bowel capsule endoscopy is debatable. Cross-sectional imaging<br />may be more accurate than small bowel capsule endoscopy for the diagnosis of large small bowel tumors. The Smooth Protruding Index on Capsule Endoscopy (SPICE score) may help to differentiate submucosal tumors from innocent bulges. Small bowel capsule endoscopy is also a key diagnostic instrument in patients with suspected Crohn’s disease and non-diagnostic ileocolonoscopy; it may also influence prognosis and therapeutic management, by determining disease extent and activity in patients with known Crohn’s disease. The role of small bowel capsule endoscopy to investigate possible complications in patients with non-responsive coeliac<br />disease is evolving.<br /><strong>Conclusions:</strong> Small bowel capsule endoscopy is a valuable diagnostic instrument for patients with obscure gastrointestinal bleeding and/or suspected small bowel tumors; it may also be a key examination in patients with suspected Crohn’s disease, or patients with known Crohn’s disease to fully assess disease extension and activity; finally, it may contribute for the diagnosis of complications of non-responsive coeliac disease.</p>

scholarly journals Capsule Endoscopy for Obscure Gastrointestinal Bleeding: A Single‑Center Experience

2018 ◽  
Vol 09 (04) ◽  
pp. 168-175 ◽  
Author(s):  
Virender Chauhan ◽  
Vasudha Goel ◽  
Mukesh Jain ◽  
Gaurav Gupta ◽  
Rupesh Pokharna ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Specific Treatment ◽  
Obscure Gastrointestinal Bleeding ◽  
Female Ratio ◽  
Worm Infestation

ABSTRACT Background: Capsule endoscopy (CE) has an established role in evaluating obscure gastrointestinal bleeding (OGIB). The aim was to know the diagnostic yield of CE and spectrum of OGIB. Materials and Methods: In this retrospective study, we evaluated all the patients with obscure gastrointestinal bleed using MiroCam capsule endoscope (IntroMedic, Seoul, Korea) between February 2014 and March 2018. Clinical data, ancillary investigations, and response to specific treatment were considered to confirm CE findings. Results: Out of 102 patients included in the study (mean age 54.5 ± 16.1 years, male: female ratio = 1.83:1) OGIB‑overt and OGIB‑occult was present in 46 and 56 patients, respectively. Diagnostic yield of CE was similar in both the groups (overt‑37/46, 80.4% versus occult‑37/56, 66.5%) (P ≥ 0.05), although there was trend to find more lesions in overt group. Overall positive diagnostic yield was 72.5%. Lesions detected were vascular malformations in 21 (20.5%), nonsteroidal anti‑inflammatory drug enteropathy in 13 (12.7%), small bowel ulcerations in 27 (26.4%), which were further divided into three subgroups (a) nonspecific ulcerations 11 (10.7%), (b) tubercular ulcer with/without stricture in 7 (6.8%) and (c) serpiginous ulcers and fissuring with cobble‑stone appearance suggestive of Crohn’s disease in 9 (8.8%), portal hypertensive enteropathy in 5 (4.9%), worm infestation (hookworms in 3, roundworms 1) in 4 (3.9%), and small bowel tumour in 1 (0.98%) patient. Overall, 56.7% patients were having definitive (P2) lesions (Saurin classification). Two patients had retention of capsule, but none developed intestinal obstruction. Capsule was removed with surgical intervention. Conclusion: CE has high diagnostic yield, relative safety and tolerability, and it is an important diagnostic tool for OGIB. Small bowel tuberculosis, Crohn’s disease and Worm infestation continue to be commonly recognized causes of OGIB in developing countries like India.

scholarly journals Massive Obscure Overt Gastrointestinal Bleed: An Unusual Cause diagnosed by Capsule Endoscopy

2012 ◽  
Vol 46 (1) ◽  
pp. 37-39 ◽  
Author(s):  
Surjeet Singh ◽  
Chalapathi Rao ◽  
Surinder S Rana ◽  
Amit Bhauwala ◽  
Kartar Singh ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Unusual Case ◽  
Tropical Countries ◽  
Gastrointestinal Bleed ◽  
Common Causes

ABSTRACT Common causes for obscure overt gastrointestinal bleeding originating from the small bowel include small bowel angioectasias, Crohn's disease, ulcers and tumors. In tropical countries, intestinal ulcerations secondary to tuberculosis and parasitic infestations have also been described as causes of gastrointestinal bleeding. We present a very unusual case of massive obscure overt gastrointestinal bleeding due to massive hookworm infestation of the small bowel that was diagnosed by capsule endoscopy and successfully treated with oral albendazole. How to cite this article Rao C, Sharma A, Rana SS, Bhauwala A, Singh S, Singh K, Bhasin DK. Massive Obscure Overt Gastrointestinal Bleed: An Unusual Cause diagnosed by Capsule Endoscopy. J Postgrad Med Edu Res 2012;46(1):37-39.

Capsule Endoscopy: A Meta-Analysis for Use with Obscure Gastrointestinal Bleeding and Crohn's Disease

2006 ◽  
Vol 16 (2) ◽  
pp. 229-250 ◽  
Author(s):  
Jonathan A. Leighton ◽  
Stuart L. Triester ◽  
Virender K. Sharma
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Meta Analysis ◽  
Obscure Gastrointestinal Bleeding
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