The role of capsule endoscopy after negative CT enterography in patients with obscure gastrointestinal bleeding

Heo, Hyun Mi; Park, Chan Hyuk; Lim, Joon Seok; Lee, Jin Ha; Kim, Bo Kyung; Cheon, Jae Hee; Kim, Tae Il; Hong, Sung Pil

doi:10.1007/s00330-011-2374-1

Cited by 36 publications

(32 citation statements)

References 27 publications

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“…The overall sensitivity of CTE is low (50%), however it is effective for detecting small bowel tumours (sensitivity exceeding 90%) [77][78][79] . The diagnostic yield of CE following negative CTE is high, 57% in one study [25] . Small bowel ulcers are the most commonly missed lesions with CTE which are readily detected by CE [1] .…”

Section: Computed Tomography Enterographymentioning

confidence: 86%

“…In the overt OGIB group, the diagnostic yield was inversely proportional to the length of time since the last bleeding episode, as delay in the use of CE allows for healing of the bleeding site [24] . CE thus has its highest diagnostic yield in patients with ongoing and overt bleeding [16,25] . CE has been shown to be superior to other modalities including computed tomography, and small bowel barium studies [26][27][28][29] .…”

Section: Capsule Endoscopymentioning

confidence: 99%

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Evaluation and outcomes of patients with obscure gastrointestinal bleeding

Santhakumar

Liu

2014

WJGP

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Core tip: This article examines the role of current diagnostic modalities for the investigation of obscure gastrointestinal bleeding (OGIB) and outcomes in patients undergoing these investigations. Capsule endoscopy and double balloon enteroscopy remain the cornerstone of diagnostic and therapeutic management. The diagnostic and therapeutic capabilities of certain modalities are influenced by the nature of bleeding in OGIB. Longterm outcome data in patients with OGIB is limited but is most promising for capsule endoscopy.Santhakumar C, Liu K. Evaluation and outcomes of patients with obscure gastrointestinal bleeding. World J Gastrointest Pathophysiol 2014; 5(4

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Section: Computed Tomography Enterographymentioning

confidence: 86%

Section: Capsule Endoscopymentioning

confidence: 99%

Evaluation and outcomes of patients with obscure gastrointestinal bleeding

Santhakumar

Liu

2014

WJGP

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“…Third, it seemed easier to diagnose active bleeding by CE than by DBE (100% vs 50%), but there was no significant difference, which implied that more cases may be necessary in the future. Previous studies have demonstrated that the CE etiology detection rate of active bleeding may be improved if an appropriate opportunity is chosen [9][10][11] . During the early bleeding stage (87%) and the overt stage (56%), CE yielded a higher positive ratio (87% and 56%) than the occult or bleeding-cessation stage (12.9%) [12,13] .…”

Section: Discussionmentioning

confidence: 99%

Different roles of capsule endoscopy and double-balloon enteroscopy in obscure small intestinal diseases

Zhang¹,

Chun-hua²,

Li³

2015

WJG

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AIM:To compare the roles of capsule endoscopy (CE) and double-balloon enteroscopy (DBE) in the diagnosis of obscure small bowel diseases. December 2014, 88 patients were included in this study; the patients had undergone gastroscopy, colonoscopy, radiological small intestinal barium meal, abdominal computed tomography or magnetic resonance imaging scan and mesenteric angiography, but their diagnoses were still unclear. The patients with gastrointestinal obstructions, fistulas, strictures, or cardiac pacemakers, as well as pregnant women, and individuals who could not accept the capsule-retention or capsule-removal surgery were excluded. Patients with heart, lung and other vital organ failure diseases were also excluded. Everyone involved in this study had undergone CE and DBE. The results were divided into: (1) the definite diagnosis (the diagnosis was confirmed at least by one of the biopsy, surgery, pathology or the drug treatment effects with follow-up for at least 3 mo); (2) the possible diagnosis (a possible diagnosis was suggested by CE or DBE, but not confirmed by the biopsy, surgery or follow-up drug treatment effects); and (3) the unclear diagnosis (no exact causes were provided by CE and DBE for the disease). The detection rate and the diagnostic yield of the two methods were compared. in the etiologies between CE and DBE was estimated, and the different possible etiologies caused by the age groups were also investigated. METHODS: From June 2009 toRESULTS: CE exhibited a better trend than DBE for diagnosing scattered small ulcers (P = 0.242, Fisher' s test), and small vascular malformations (χ 2 = 1.810, P = 0.179, Pearson χ 2 test), but with no significant differences, possible due to few cases. However, DBE was better than CE for larger tumors (P = 0.018, Fisher's test) and for diverticular lesions with bleeding ulcers (P = 0.005, Fisher's test). All three hemangioma cases diagnosed by DBE in this study (including sponge hemangioma, venous hemangioma, and hemangioma with hamartoma lesions) were all confirmed by biopsy. Two parasite cases were found by CE, but were negative by DBE. This study revealed no obvious differences in the detection rates (DR) of CE (60.0%, 53/88) and DBE (59.1%, 52/88). However, the etiological diagnostic yield (DY) difference was apparent. The CE diagnostic yield was 42.0% (37/88), and the DBE diagnostic yield was 51.1% (45/88). Furthermore, there were differences among the age groups (χ 2 = 22.146, P = 0.008, Kruskal Wallis Test). Small intestinal cancer (5/6 cases), vascular malformations (22/29 cases), and active bleeding (3/4 cases) appeared more commonly in the patients over 50 years old, but diverticula with bleeding ulcers were usually found in the 15-25-year group (4/7cases). The over-25-year group accounted for the stromal tumors (10/12 cases).CONCLUSION: CE and DBE each have their own advantages and disadvantages. The appropriate choice depends on the patient's age, tolerance, and clinical manifestations. Sometimes CE followed by DBE is necessary. Core t...

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“…With regard to CT examinations, the type of CT, method of dye injection, method of administering the contrast medium, and the type of oral contrast in this study were mixed. However, previous studies have found differences in the pharmaceuticals used as oral neutral contrast agents and their administration (11,12,20,21). In addition, although higher diagnostic yields of CE compared with CT and of CTE compared with CE have been reported, CT and CTE can not be compared directly.…”

Section: Original Article Jeon Et Al Capsule Endoscopy and Computed mentioning

confidence: 99%

Is there a difference between capsule endoscopy and computed tomography as a first-line study in obscure gastrointestinal bleeding?

Jeon¹,

Kim²,

gun³

et al. 2014

Turk J Gastroenterol

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Background/Aims: Capsule endoscopy (CE) is currently recommended as the first-line study in the evaluation of obscure gastrointestinal bleeding (OGIB), while computed tomography (CT) is often thought of as complementary to CE. This study evaluated CT as a first-line study in OGIB and compared it with CE. Materials and Methods: Ninety-nine patients with OGIB who received both CE and CT were included. CT included conventional CT and CT enterography (CTE). Patients were divided into two groups: the CT before CE group (CT first group; n=75) and the CE before CT group (CE first group; n=24). The two groups were compared retrospectively. Results: Overt OGIB was present in 92% of patients. Mucosal lesions (46%) were the most common diagnoses, while tumors accounted for 7%. The diagnostic yield of CE was significantly higher than that of CT for both groups (CT first group, p<0.001; CE first group, p=0.013). In the CT first group, the diagnostic yield using both CT and CE (48/75; 64%) was significantly higher than that for CT alone (12/75; 16%, p=0.005). In the CE first group, the diagnostic yield with both CT and CE versus CE alone was 70.9% versus 62.5%, respectively, with a significant difference (p=0.045). Conclusion: There was no significant clinical difference associated with the order in which the tests were performed. However, CE and CT, when used together, had a significantly greater diagnostic yield than did CE or CT when used alone.

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The role of capsule endoscopy after negative CT enterography in patients with obscure gastrointestinal bleeding

Cited by 36 publications

References 27 publications

Evaluation and outcomes of patients with obscure gastrointestinal bleeding

Evaluation and outcomes of patients with obscure gastrointestinal bleeding

Different roles of capsule endoscopy and double-balloon enteroscopy in obscure small intestinal diseases

Is there a difference between capsule endoscopy and computed tomography as a first-line study in obscure gastrointestinal bleeding?

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