Impact of Inpatient Status on Diagnostic Yield and Clinical Outcome of Video Capsule Endoscopy (VCE) in the Evaluation of Obscure Gastrointestinal Bleeding (OGIB)

2014 ◽  
Vol 109 ◽  
pp. S111-S112
Author(s):  
Wiley Truss ◽  
Arvind Tripathi ◽  
Frederick Weber ◽  
Shajan Peter
Keyword(s):  
Clinical Outcome ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Video Capsule Endoscopy ◽  
Obscure Gastrointestinal Bleeding

scholarly journals Clinical Impact of Small Bowel Capsule Endoscopy in Obscure Gastrointestinal Bleeding

Medicina ◽  
2020 ◽  
Vol 56 (10) ◽  
pp. 548
Author(s):  
Ana-Maria Singeap ◽  
Camelia Cojocariu ◽  
Irina Girleanu ◽  
Laura Huiban ◽  
Catalin Sfarti ◽  
...  
Keyword(s):  
Small Bowel ◽  
Clinical Outcome ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Obscure Gastrointestinal Bleeding ◽  
Deficiency Anemia ◽  
Occult Gastrointestinal Bleeding ◽  
Therapeutic Decisions

Background and objectives: The most frequent indications for small bowel capsule endoscopy (SBCE) are obscure gastrointestinal bleeding (OGIB) and iron deficiency anemia (IDA). The aim of this study was to evaluate the diagnostic yield (DY) of SBCE in overt and occult OGIB, as well as its impact on the clinical outcome. Materials and Methods: This study retrospectively included all cases of OGIB investigated by SBCE in a tertiary care referral center, between 1st January 2016 and 31st December 2018. OGIB was defined by overt or occult gastrointestinal bleeding, with negative upper and lower endoscopy. Occult gastrointestinal bleeding was either proved by a fecal test or presumptively incriminated as a cause for IDA. DY was defined as the detection rate for what were thought to be clinically significant findings. DYs for overt and occult bleeding were assessed and compared. Gender, age, hemoglobin levels, NSAID consumption and the use of anticoagulants were recorded. Following SBCE results, individual therapeutic decisions were made, and follow-up data were recorded. Results: 224 SBCE examinations were performed for OGIB, of which 148 were for overt OGIB, and 76 for unexplained IDA. Positive findings were found in 139 patients, resulting in an overall DY for OGIB of 62%, higher in overt OGIB (75%) compared to IDA (37%). The most frequent findings were small bowel angioectasias (62.2% in overt OGIB and 78.5% in IDA). On multivariate logistic regression analysis, only hemoglobin level <10 g/dL and anticoagulants were the variables independently associated with positive findings. All patients received medical, endoscopic or surgical treatment and had good clinical outcome during follow-up. Conclusion: SBCE has a high diagnostic yield and a positive impact on management of patients with OGIB.

scholarly journals Video Capsule Endoscopy Optimal Timing in Overt Obscure Gastrointestinal Bleeding

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 154
Author(s):  
Joo Hye Song ◽  
Ji Eun Kim ◽  
Hwe Hoon Chung ◽  
Sung Noh Hong ◽  
Heejung Kim ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Therapeutic Intervention ◽  
Diagnostic Yield ◽  
Medical Center ◽  
Lesion Detection ◽  
Video Capsule Endoscopy ◽  
Obscure Gastrointestinal Bleeding ◽  
Optimal Timing ◽  
The Times

Video capsule endoscopy (VCE) has become the noninvasive diagnostic standard in the investigation of overt obscure gastrointestinal bleeding (OGIB), with a high positive and negative predictive value. However, the diagnostic yield of the VCE is thought to depend on when it was performed. We evaluate the optimal timing performing VCE relative to overt OGIB to improve the diagnostic yield. A total 271 patients had admitted and underwent VCE for overt OGIB between 2007 and 2016 in Samsung Medical Center, Seoul, Korea. To evaluate the diagnostic yield of VCE for overt OGIB with respect to timing of the intervention, diagnostic yield was analyzed according to the times after latest bleeding. The finding of VCE was classified into P0 or P1 (no potential for bleeding or uncertain hemorrhagic potential) and P2 (high potential for bleeding, such as active bleeding, typical angiodysplasia, large ulcerations or tumors). The P2 lesion was found in 106 patients and diagnostic yield of was 39.1% for overt OGIB. Diagnostic yield of VCE to detect P2 lesion was higher when it is performed closer to the time of latest bleeding (timing of VCE between the VCE and latest bleeding: <24 h, 43/63 (68.3%); 1 days, 16/43 (34.9%); 2 days, 18/52 (34.6%); 3 days, 13/43 (30.2%); 4 days, 7/28 (25.0%); 5–7 days, 6/24 (25.0%), and ≥8 days, 4/18 (22.2%); ptrend <0.001). The interval between the VCE and latest bleeding were categorized into <24 h (n = 63), 1–2 days (n = 95), 3–7 days (n = 95) and ≥8 days (n = 18). Multivariable analyses showed the odds ratio for P2 lesion detection was 4.99 (95% confidence interval, 1.47–16.89) in <24 h group, compared with ≥8 days group (p < 0.010). The overall re-bleeding rate for those with P2 lesion was higher than for those with P0 or P1 lesion at the end of mean follow up of 2.5 years. The proportion of patients who underwent therapeutic intervention including surgery, endoscopic intervention and embolization was higher when VCE is performed closer to the time of latest bleeding (p = 0.010). Early deployment of VCE within 24 h of the latest GI bleeding results in a higher diagnostic yield for patients with overt OGIB and consequently resulted in a higher therapeutic intervention rate.

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