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The role of capsule endoscopy in etiological diagnosis and management of obscure gastrointestinal bleeding

Intestinal Research
2016년 14권 1호 p.69 ~ p.74
 ( Vikas Pandey ) - India Lokmanya Tilak Municipal Medical College General Hosiptal Department of Gastroenterology

 ( Meghraj Ingle ) - India Lokmanya Tilak Municipal Medical College General Hosiptal Department of Gastroenterology
 ( Nilesh Pandav ) - India Lokmanya Tilak Municipal Medical College General Hosiptal Department of Gastroenterology
 ( Pathik Parikh ) - India Lokmanya Tilak Municipal Medical College General Hosiptal Department of Gastroenterology
 ( Jignesh Patel ) - India Lokmanya Tilak Municipal Medical College General Hosiptal Department of Gastroenterology
 ( Aniruddha Phadke ) - India Lokmanya Tilak Municipal Medical College General Hosiptal Department of Gastroenterology
 ( Prabha Sawant ) - India Lokmanya Tilak Municipal Medical College General Hosiptal Department of Gastroenterology

Abstract

Background/Aims: To investigate the various etiologies, yields, and effects of capsule endoscopy (CE) on management and complications, along with follow up of patients with obscure gastrointestinal (GI) bleeding.

Methods: The study group of patients included those having obscure, overt, or occult GI bleeding. The findings were categorized as (A) obvious/definitive, (B) equivocal, or (C) negative. Any significant alteration in patient management post CE in the form of drug or surgical intervention was noted.

Results: Total patients included in the study were 68 (48 males and 20 females). The ratio of male:female was 2.4:1. The age ranged between 16 years to 77 years. Mean age for males was 62±14 years, for females 58±16 years. The total yield of CE with definitive lesions was in 44/68 (65.0%) of patients. In descending order (A) angiodysplasia 16/68 (23.53%), (B) Crohn's disease 10/68 (14.70%), (C) non-steroidal anti-inflammatory drug enteropathy 8/68 (11.76%), (D) small bowel ulcers 4/68 (5.88%), (E) jejunal and ileal polyps 2/68 (2.94%), (F) intestinal lymphangiectasis 2/68 (2.94%), and (G) ileal hemangiomas 2/68 (2.94%) were followed. Equivocal findings 12/68 (17.65%) and negative study 12/68 (17.65%) was found. Complications in the form of capsule retention in the distal ileum were noted in 2/68 (2.94%) subjects. Statistically, there was a higher probability of finding the etiology if the CE was done during an episode of bleeding.

Conclusions: CE plays an important role in diagnosing etiologies of obscure GI bleeding. Its role in influencing the management outcome is vital.

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