Capsule Endoscopy Findings in Patients With Occult or Overt Bleeding Older Than 80 years

Tsibouris, Panagiotis; Kalantzis, C.; Apostolopoulos, Periklis; Alexandrakis, Georgios; Mavrogianni, Panagiota; Kalantzis, Nikolaos

doi:10.1111/j.1443-1661.2011.01197.x

Cited by 23 publications

(25 citation statements)

References 22 publications

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“…[19] However, this improved efficacy should be balanced by the worsening of the side effects of these explorations in elderly patients. [20] Moreover, no specific guidelines are available for patients aged over 65 years.…”

Section: Introductionmentioning

confidence: 99%

Outcome of endoscopy-negative iron deficiency anemia in patients above 65

et al. 2016

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After the age of 65 years, iron deficiency anemia (IDA) requires the elimination of digestive neoplasia and is explored with upper and lower gastrointestinal (GI) endoscopy. However, such explorations are negative in 14% to 37% of patients. To further evaluate this issue, we evaluated the outcomes of patients aged over 65 years with endoscopy-negative IDA.We retrospectively analyzed the outcomes of in-patients over the age of 65 years with IDA (hemoglobin <12 g/dL and ferritin <70 μg/L) who had negative complete upper and lower GI endoscopies in 7 tertiary medical hospitals. Death, the persistence of anemia, further investigations, and the final diagnosis for IDA were analyzed after at least 12 months by calling the patients’ general practitioners and using hospital records.Between 2004 and 2011, 69 patients (74% women) with a median age of 78 (interquartile range (IQR) 75–82) years and hemoglobin and ferritin levels of 8.4 (IQR 6.8–9.9) g/dL and 14 (IQR 8–27) μg/L, respectively, had endoscopy-negative IDA, and 73% of these patients received daily antithrombotics. After a follow-up of 41 ± 22 months, 23 (33%) of the patients were dead; 5 deaths were linked with the IDA, and 45 (65%) patients had persistent anemia, which was significantly associated with death (P = 0.007). Further investigations were performed in 45 patients; 64% of the second-look GI endoscopies led to significant changes in treatment compared with 25% for the capsule endoscopies. Conventional diagnoses of IDA were ultimately established for 19 (27%) patients and included 3 cancer patients. Among the 50 other patients, 40 (58%) had antithrombotics.In endoscopy-negative IDA over the age of 65 years, further investigations should be reserved for patients with persistent anemia, and second-look GI endoscopy should be favored. If the results of these investigations are negative, the role of antithrombotics should be considered.

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Section: Introductionmentioning

confidence: 99%

Outcome of endoscopy-negative iron deficiency anemia in patients above 65

et al. 2016

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“…A retrospective analysis reviewing the safety, tolerability, and findings of capsule endoscopy in the elderly found no significant differences in small bowel transit time or overall safety relative to a matched younger cohort. 88 However, the elderly participants were significantly more likely to label the procedure as tiresome and difficult. 88 The largest cohort study revealed that patients older than 80 were not more likely to suffer adverse events, defined as aspiration or capsule retention, compared with younger participants.…”

Section: Videocapsule Endoscopymentioning

confidence: 99%

“…88 However, the elderly participants were significantly more likely to label the procedure as tiresome and difficult. 88 The largest cohort study revealed that patients older than 80 were not more likely to suffer adverse events, defined as aspiration or capsule retention, compared with younger participants. 89 Further analysis showed capsule endoscopy to have a higher diagnostic yield in the over 80 population (73%) compared with the younger participants (55%) because of higher frequency of vascular lesions (angiodysplasia).…”

Section: Videocapsule Endoscopymentioning

confidence: 99%

Endoscopy in the Elderly

Razavi

Gross

Katz

2014

Clinics in Geriatric Medicine

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“…There is scarcity of data on the use of CE in octogenarians. [2][3][4] We aim to report our centre experience in using CE in octogenarians. Methods Retrospective study; the SBCE data base of our unit was interrogated for patients >80 years of age who underwent CE.…”

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confidence: 99%

PTU-017 The Use Of Small Bowel Capsule Endoscopy In The Octogenarians Group; The Edinburgh Experience

Bartzis

Koulaouzidis

2014

Gut

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cell carcinoma and 2 benign diseases. SEMS deployment was successful in all 110 procedures. Of the 46 traversable tumours, 22 underwent ET and 24 FT for SEMS placement. 64 patients had non traversable tumours (with standard endoscope). HT was used in 21 and FT in 43 patients. Length of the stent deployed was not statistically different in both groups (HT 11.4 ± 0.5 cm, FT 11.0 ± 0.5 cm, P = 0.98). Good dysphagia alleviation was seen in both groups (dysphagia scores, HT cohort pre-stent 2.7 ± 0.16, post-stent 0.53 ± 0.87 P < 0.001; FT cohort prestent 2.53 ± 0.09, post-stent 0.44 ± 0.11 P < 0.001). Cumulative complications (reflux, pain, bleeding, food bolus obstruction) were similar for both techniques (HT 0.28 ± 0.1, FT 0.34 ± 0.1, P = 0.62). There was a tendency towards higher re-intervention for tumour overgrowth in the FT cohort (FT 7/43 patients, 129.4 ± 35.5 days; HT 2/21 patients, 215 ± 60 day, P = 0.33). Neither the stent length (P = 0.89) nor the technique used, had an influence on the need for re-stenting for tumour overgrowth (P = 0.68). Median survival was 141 days in the HT group and 121 days Introduction The localisation of a wireless capsule endoscope (WCE) within the small-bowel is typically performed by wearable radiofrequency sensors triangulation. The accuracy of this approach is low.1 Only a few approaches have been proposed for WCE localisation based on visual features. These include methods addressing the estimation of the rotation angle of the capsule 2,3 and temporal video segmentation methods. 4 We present a WCE localisation method, based only on visual information extracted from conventional WCE recording. Methods Automatic detection of points of interest (POI) in WCE video frames, matching of the detected POI between consecutive frames, and determination of actual correspondences between subsets of these POI based on the random sample consensus (RANSAC) algorithm was performed. Maximally stable extremal regions (MSER) algorithm, instead of the speeded up feature extraction (SURF) algorithm, was used. Based on the scaling and the rotation of the content of the consecutive WCE frames, it is possible to estimate the displacement and the rotation of the capsule within the GI tract. For the ex-vivo experiment; a standard simulated intestinal environment was created. Markers were sewn (at set, pre-recorded distances) onto the luminal surface of porcine small-bowel through which a capsule (MiroCam®, IntroMedic Co Ltd, Seoul, Korea) was propelled.Results Comparative experiments using both SURF and MSER features, which indicated the superiority of the former over the latter, we conducted. We worked on a corpus of 1070 WCE frames (634 indicating forward motion, 436 indicating backward motion). The accuracy using SURF features was 81.5% (87.2% on forward motion, 73.2% on backward motion), while using MSER was 67.2% (79.8% on forward motion, and 48.9% backward motion). Noteworthy, the proposed algorithm often fails when using MSER (6.7% of frames while <0.1% when using SURF) and a transform is ...

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Capsule Endoscopy Findings in Patients With Occult or Overt Bleeding Older Than 80 years

Abstract: WCE is feasible, although rather tiresome, in patients over the age of 80. Though the vast majority of patients older than 80 presented with angiodysplasias, there were no differences between the aged and younger groups in the presence of ulcerative lesions and polyps or tumors.

Cited by 23 publications

References 22 publications

Outcome of endoscopy-negative iron deficiency anemia in patients above 65

Outcome of endoscopy-negative iron deficiency anemia in patients above 65

Endoscopy in the Elderly

PTU-017 The Use Of Small Bowel Capsule Endoscopy In The Octogenarians Group; The Edinburgh Experience

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