Optimal Timing of Small Bowel Capsule Endoscopy in Acute Small Bowel Bleeding: A Meta-Analysis

Introduction. The small bowel capsule endoscopy is the first line procedure in patients with suspected small bowel bleeding. Data regarding overt suspected small bowel bleeding and its predictive factors remain still limited. Aim. To assess the diagnostic yield of the capsule endoscopy and the factors predicting positive findings in patients with overt suspected small bowel bleeding. Methods. Patients with overt suspected small bowel bleeding (melena or enterorrhagia) and negative upper and lower endoscopy were included. A positive diagnostic yield was considered when the capsule endoscopy diagnosed one or more P2 or P3 type lesions (Modified Saurin Classification) Demographic and laboratory data were recorded. Results. 79 patients were included (mean age 62.92 (15-89); F:M 46:33). The diagnostic yield of the capsule endoscopy was 62%. The most frequent finding was angioectasia (44.8%), followed by nonspecific inflammation/ulceration (20.4%). The multivariate analysis found that age older than 50 years and male sex were independent variables that were associated with an increased risk of positive findings and angioectasia. Conclusions. In this group of patients with overt suspected small bowel bleeding, the capsule endoscopy was useful (with a diagnostic yield of 62%). The most frequent lesions were the vascular ones. Age over 50 and male sex were independent predictors of finding lesions and angioectasia.

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630 Inpatient Capsule Endoscopy Does Not Lead to Increased Hospital Interventions in Stable Small Bowel Bleeding

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000592056.63353.30 ◽

2019 ◽

Vol 114 (1) ◽

pp. S367-S367

Author(s):

Henry Jen ◽

Leona Al Sayah ◽

Daniel Sosa ◽

Erin Taub ◽

Farah Monzur

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Small Bowel Bleeding

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Clinical validity of flexible spectral imaging color enhancement (FICE) in small-bowel capsule endoscopy: a systematic review and meta-analysis

Endoscopy ◽

10.1055/s-0042-122015 ◽

2017 ◽

Vol 49 (03) ◽

pp. 258-269 ◽

Cited By ~ 17

Author(s):

Diana Yung ◽

Pedro Boal Carvalho ◽

Andry Giannakou ◽

Uri Kopylov ◽

Bruno Rosa ◽

...

Keyword(s):

Systematic Review ◽

Small Bowel ◽

Capsule Endoscopy ◽

Meta Analysis ◽

Spectral Imaging ◽

Clinical Validity ◽

Color Enhancement

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Su1192 Predictors of Active Small Bowel Bleeding Warrant Early Capsule Endoscopy

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2017.03.708 ◽

2017 ◽

Vol 85 (5) ◽

pp. AB309

Author(s):

Sara Monteiro ◽

Pedro Boal Carvalho ◽

Tiago Cúrdia Gonçalves ◽

Maria João Moreira ◽

Bruno Rosa ◽

...

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Small Bowel Bleeding

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Aortoenteric fistula: a rare but critical cause of small bowel bleeding discovered on capsule endoscopy

BMJ Case Reports ◽

10.1136/bcr-2019-230083 ◽

2019 ◽

Vol 12 (5) ◽

pp. e230083

Author(s):

Matt Davie ◽

Diana E Yung ◽

John N Plevris ◽

Anastasios Koulaouzidis

Keyword(s):

Small Bowel ◽

Capsule Endoscopy ◽

Abdominal Aortic Aneurysm Repair ◽

Sudden Onset ◽

Aortoenteric Fistula ◽

Good Effect ◽

Stent Grafting ◽

Abdominal Aortic ◽

History Of ◽

Small Bowel Bleeding

A 78-year-old man attended for outpatient capsule endoscopy, to investigate a recent history of unexplained small bowel bleeding. His previous medical history included an abdominal aortic aneurysm repair 6 years ago. Soon after capsule ingestion, he experienced sudden onset abdominal pain and collapsed on hospital grounds. He was rapidly transferred to the emergency department as he was haemodynamically unstable, and a significant per rectum (PR) bleed was found on examination. The patient was quickly stabilised following fluid resuscitation. CT angiography was performed which did not show active bleeding. However, use of the real-time capsule viewer indicated a profuse active jejunal bleed originating from the aortic graft, suggestive of an aortoenteric fistula. The patient underwent emergency endovascular cuff placement, and subsequent endovascular abdominal aortic stent grafting, to good effect.

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