Abstract |
Small bowel capsule endoscopy (SBCE) visualizes the small bowel (SB) mucosa. Gastrointestinal (GI) bleeding from SB accounts for the majority of SBCE indications. We aimed to assess, in a "real-world" prospective study, the diagnostic yield of SBCE in a cohort of consecutive patients with obscure gastrointestinal bleeding (OGIB). Secondary end point was to assess the frequency of adverse events and the role of SBCE in determining the diagnostic work-up and clinical outcome. From 2016 to 2018, all patients referred for SBCE examination were enrolled. Indication for SBCE was re-assessed by 2 dedicated gastroenterologists. Inclusion criteria: (1) age ≥ 18 and ≤ 85 years; (2) diagnosis of OGIB; 3) non-diagnostic standard bidirectional endoscopy; (4) informed consent. Exclusion criteria: (1) deglutition impairment; (2) SBCE contraindications; (3) pregnancy. The cohort included 50 patients [males 18 (36%), age 68 (27-83)]. SBCE indication: patients with ongoing overt OGIB (Group A) (n = 11; 22%), previous overt OGIB (Group B) (n = 14; 28%), occult bleeding (with Iron Deficiency Anaemia) (Group C) (n = 25; 50%). SBCE detected clinically relevant lesions in 46 (92%) cases. Clinically relevant lesions were more frequent in Group C (24/25; 96%), followed by Group A (10/11; 91%) and Group B (12/14; 85.5%). After SBCE, treatment was medical (60%); endoscopic (14%), surgical (36%) or conservative (18%). Clinical follow-up showed complete resolution in 63.2%, partial/absent resolution in 18.4% of cases. In a prospective study, the high diagnostic yield of SBCE supports its role as first-line investigation in patients with OGIB. However, this achievement requires an accurate and timely assessment by dedicated gastroenterologists.
|
Authors | Samanta Romeo, Benedetto Neri, Michelangela Mossa, Maria Elena Riccioni, Ludovica Scucchi, Giorgia Sena, Saverio Potenza, Carmelina Petruzziello, Livia Biancone |
Journal | Internal and emergency medicine
(Intern Emerg Med)
Vol. 17
Issue 2
Pg. 349-358
(03 2022)
ISSN: 1970-9366 [Electronic] Italy |
PMID | 34176039
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
|
Copyright | © 2021. The Author(s). |
Topics |
- Aged
- Aged, 80 and over
- Capsule Endoscopy
- Gastrointestinal Hemorrhage
(diagnosis, therapy)
- Humans
- Intestine, Small
- Male
- Prospective Studies
- Retrospective Studies
|