The role of capsule endoscopy in obscure gastrointestinal bleeding

Abstract 

Background and study aim

Obscure gastrointestinal bleeding is mostly recurrent and originates in the small bowel, which can be only partially examined by conventional endoscopy. Capsule endoscopy has revolutionized the evaluation of obscure gastrointestinal bleeding (OGIB). The diagnostic yield of capsule endoscopy in OGIB was a main concern of many studies. The aim of this study is to assess the diagnostic yield of capsule endoscopy in cases of OGIB. Capsule-related complications and degree of inter-observer variation will be recorded as well.

Patients and methods

54 consecutive patients suffering from OGIB, whether occult or overt, were subjected to capsule examination and data analysis.

Results

The majority (74.1%) presented with obscure overt bleeding. Examination was complete in 68.4%. The commonest lesions were angiodysplasias (17.5%). Examinations were negative for lesions in 35.1% and hampered by limitations in 19.3%. The capsule diagnostic yield was 56.1%, while capsule retention occurred in 3.5%. The inter-observer agreement for the cause of bleeding was 91.2%.

Conclusions

Capsule endoscopy proved helpful in solving the mystery of OGIB. It succeeded in diagnosing the cause of bleeding and directing further management with good compliance, high proportion of inter-observer agreement and low incidence of complications.

Keywords: Capsule endoscopy, Obscure gastrointestinal bleeding