Video capsule endoscopy as the initial examination for overt obscure gastrointestinal bleeding can efficiently identify patients who require double-balloon enteroscopy

BMC Gastroenterology

Research Article

Yoshimasa Maeda¹  Kosaku Moribata¹  Jun Kato¹  Takao Maekita¹  Hideyuki Tamai¹  Mikitaka Iguchi¹  Izumi Inoue¹  Masao Ichinose¹  Hisanobu Deguchi¹ 

[1] Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-0012, Wakayama City, Wakayama, Japan;

关键词: Video capsule endoscopy;    Overt OGIB;    Double-balloon enteroscopy;    Choice of route;   

DOI  :  10.1186/s12876-015-0362-7

 received in 2015-06-01, accepted in 2015-10-01,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundBoth 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.MethodsEighty-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.ResultsThirty-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.ConclusionsVCE 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】

CC BY   
© Maeda et al. 2015