Diagnostic Value of Endoscopic Capsule in Patients with Obscure Digestive Bleeding: Blinded Comparison with Video Push-Enteroscopy

Saurin, J.-C.; Delvaux, Michel; Gaudin, Jean-Louis; Fassler, Isaac; Villarejo, J.; Vahedi, Kouroche; Bitoun, A; Canard, J. M.; Souquet, J. C.; Ponchon, Thierry; Florent, C

doi:10.1055/s-2003-40244

Cited by 394 publications

(91 citation statements)

References 16 publications

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“…The entire small bowel can usually be visualized by VCE without painful intubation. However, the clinical relevance of the various lesions observed during capsule recordings is so far not fully understood [19]. It is noted that the indefinite findings were made by VCE in one-quarter of the patients in our study.…”

Section: Discussionmentioning

confidence: 54%

A Prospective Study on Evaluating the Diagnostic Yield of Video Capsule Endoscopy Followed by Directed Double-Balloon Enteroscopy in Patients with Obscure Gastrointestinal Bleeding

Dai

Lü

et al. 2009

Dig Dis Sci

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Section: Discussionmentioning

confidence: 54%

A Prospective Study on Evaluating the Diagnostic Yield of Video Capsule Endoscopy Followed by Directed Double-Balloon Enteroscopy in Patients with Obscure Gastrointestinal Bleeding

Dai

Lü

et al. 2009

Dig Dis Sci

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“…VCE has proven itself to be the most effective examination in depicting small bowel mucosal lesions, including subtle signs of chronic inflammatory diseases [17] and obscure bleeding [18]. New capsule enteroscopes designed for oesophageal and colonic exploration are being introduced to the market [19].…”

Section: Discussionmentioning

confidence: 99%

Small bowel enteroclysis with magnetic resonance imaging and computed tomography in patients with failed and uncertain passage of a patency capsule

et al. 2012

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BackgroundVideo capsule enteroscopy (VCE) has revolutionized small bowel imaging, enabling visual examination of the mucosa of the entire small bowel, while MR enteroclysis (MRE) and CT enteroclysis (CTE) have largely replaced conventional barium enteroclysis. A new indication for MRE and CTE is the clinical suspicion of small bowel strictures, as indicated by delayed or non-delivery of a test capsule given before a VCE examination, to exclude stenosis. The aim of this study was to determine the clinical value of subsequent MRE and CTE in patients in whom a test capsule did not present itself in due time.MethodsSeventy-five consecutive patients were identified with a delayed or unnoticed delivery of the test capsule. Seventy patients consented to participate and underwent MRE (44) or CTE (26). The medical records and imaging studies were retrospectively reviewed and symptoms, laboratory results and imaging findings recorded.ResultsLesions compatible with Crohns disease were shown by MRE in 5 patients, by CTE in one and by VCE in four, one of whom had lesions on MRE. In patients without alarm symptoms and findings (weight loss, haematochezia, anaemia, nocturnal diarrheoa, ileus, fistula, abscess and abnormal blood tests) imaging studies did not unveil any such lesion. VCE's were performed in only 20 patients, mainly younger than 50 years of age, although no stenotic lesion was shown by MRE and CTE. In the remaining 50 patients no VCE or other endoscopic intervention was performed indicating that the referring physician was content with the diagnostic information from MRE or CTE.ConclusionThe diagnostic value of MRE and CTE is sufficient for clinical management of most patients with suspected small bowel disease, and thus VCE may be omitted or at least postponed for later usage.

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“…Small bowel lesions were described using the commonly employed classification of Saurin et al [29], as P0 (no bleeding potential, such as nodules and lymphangiectasias), P1 (uncertain bleeding potential, such as red spots or small erosions), and P2 (high bleeding potential, such as angioectasias, ulcers, tumors, or varices).…”

Section: Methodsmentioning

confidence: 99%

New Evidence on the Impact of Antithrombotics in Patients Submitted to Small Bowel Capsule Endoscopy for the Evaluation of Obscure Gastrointestinal Bleeding

Carvalho

Rosa

Moreira

et al. 2014

Gastroenterology Research and Practice

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Objectives. Small bowel capsule endoscopy (SBCE) plays a decisive role in the obscure gastrointestinal bleeding (OGIB) diagnosis. Antithrombotics may increase bleeding risk in patients with preexistent lesions or through direct mucosal aggression. We aimed to correlate antithrombotics usage with lesions with bleeding potential found in SBCE. Methods. Retrospective single-center study including 274 consecutive SBCE performed over 7 years for OGIB. The lesions were classified as P0 (no bleeding potential), P1 (uncertain bleeding potential: erosions), and P2 (high bleeding potential: angioectasias, ulcers, and tumors). We assessed antiplatelet and anticoagulant drug use during the 60 days preceding SBCE. Results. One-third of the patients were under antithrombotic therapy. The diagnostic yield of SBCE for P2 lesions was 30.0%. Angioectasias (20.4%) were the most frequently observed lesions. There was a significant correlation between anticoagulant drug use and a higher incidence of P2 lesions in the small bowel (43.2% versus 26.5%; OR = 2.11, P = 0.026). We found no significant correlation between antiplatelets and lesions with bleeding potential in SBCE. Conclusions. Small bowel lesions with high bleeding potential were more frequently detected when the patient was on anticoagulant drugs, resulting in a twofold risk. Antiplatelet drugs were not associated with small bowel lesions.

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Diagnostic Value of Endoscopic Capsule in Patients with Obscure Digestive Bleeding: Blinded Comparison with Video Push-Enteroscopy

Cited by 394 publications

References 16 publications

A Prospective Study on Evaluating the Diagnostic Yield of Video Capsule Endoscopy Followed by Directed Double-Balloon Enteroscopy in Patients with Obscure Gastrointestinal Bleeding

A Prospective Study on Evaluating the Diagnostic Yield of Video Capsule Endoscopy Followed by Directed Double-Balloon Enteroscopy in Patients with Obscure Gastrointestinal Bleeding

Small bowel enteroclysis with magnetic resonance imaging and computed tomography in patients with failed and uncertain passage of a patency capsule

New Evidence on the Impact of Antithrombotics in Patients Submitted to Small Bowel Capsule Endoscopy for the Evaluation of Obscure Gastrointestinal Bleeding

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