BMC Gastroenterology | |
Video capsule endoscopy as the initial examination for overt obscure gastrointestinal bleeding can efficiently identify patients who require double-balloon enteroscopy | |
Masao Ichinose1  Jun Kato1  Hideyuki Tamai1  Mikitaka Iguchi1  Takao Maekita1  Izumi Inoue1  Hisanobu Deguchi1  Kosaku Moribata1  Yoshimasa Maeda1  | |
[1] Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City 641-0012, Wakayama, Japan | |
关键词: Choice of route; Double-balloon enteroscopy; Overt OGIB; Video capsule endoscopy; | |
Others : 1234378 DOI : 10.1186/s12876-015-0362-7 |
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received in 2015-06-01, accepted in 2015-10-01, 发布年份 2015 |
【 摘 要 】
Background
Both double-balloon enteroscopy (DBE) and video capsule endoscopy (VCE) have similar diagnostic yields for patients with overt obscure gastrointestinal bleeding (OGIB). However, the choice of initial modality is still controversial. The aim of this study was to show the clinical outcome of the strategy of initial VCE, followed by DBE.
Methods
Eighty-nine consecutive overt OGIB patients who had undergone VCE as the initial examination were analyzed. The interpreters of VCE evaluated the necessity of performing DBE, and the antegrade or retrograde route was chosen, depending on the transit time of the capsule.
Results
Thirty-seven patients (42 %) underwent DBE depending on the findings of VCE. Of these, bleeding sites in the small bowel were identified in 29 patients with the initially selected route (21 antegrade and 8 retrograde). The remaining 8 later underwent DBE by the other route, but 7 had no bleeding lesion, which was confirmed by second-look VCE. One remaining patient had a jejunal varix found by VCE, but DBE from either side could not reach the lesion. The sensitivity and negative predictive value of VCE were 100 %, both for the presence of small bowel lesions and the requirement of hemostasis in the small bowel; this indicated that VCE never misses relevant findings in the small bowel, and that negative VCE findings correspond to the lack of necessity for further examination.
Conclusions
VCE as the initial examination can efficiently identify overt OGIB patients who require DBE. The strategy of initial VCE for overt OGIB appears to be reasonable.
【 授权许可】
2015 Maeda et al.
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