The Role of Capsule Endoscopy in Patients with Obscure Gastrointestinal Bleeding
Clinical Endoscopy 2016³â 49±Ç 1È£ p.16 ~ p.20
¹Î¾ç¿ø(Min Yang-Won) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
À嵿°æ(Chang Dong-Kyung) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Medicine
Abstract
Obscure gastrointestinal bleeding (OGIB) accounts for 5% of all gastrointestinal (GI) bleeding cases and is often caused by small bowel lesions. Capsule endoscopy (CE), which allows non-invasive visualization of the small bowel mucosa, has revolutionized the evaluation of OGIB. CE is preferred by both patients and physicians mainly because of its non-invasiveness, and is widely used as the first-line diagnostic modality for OGIB. The diagnostic yield of CE in OGIB has been reported to be in the range of 32% to 83%. Although no direct comparison has been made, a meta-analysis showed similar diagnostic yields between CE and double-balloon enteroscopy (DBE) for OGIB. However, CE could enhance the yield of subsequent DBE and serve as a guide for optimizing the insertion route for DBE. Even after negative CE, selected patients could benefit from second-look CE for OGIB. In terms of outcomes, a favorable clinical impact after CE has been reported in several studies. However, observations indicate that CE might not influence clinical outcomes directly, but rather play a role in selecting patients with OGIB who are likely to benefit from subsequent evaluation and intervention.
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Capsule endoscopy, Diagnosis, Obscure gastrointestinal bleeding, Outcome
KMID :
1038120160490010016
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À¯È¿¼º°á°ú(Recomendation)
Capsule endoscopy (CE) is widely used as the first-line diagnostic modality for Obscure Gastrointestinal Bleeding (OGIB); CE appears to play an essential role in the management of patients with OGIB.