The role of capsule endoscopy after negative CT enterography in patients with obscure gastrointestinal bleeding.

Heo, Hyun Mi; Park, Chan Hyuk; Lim, Joon Seok; Lee, Jin Ha; Kim, Bo Kyung; Cheon, Jae Hee; Kim, Tae Il; Kim, Won Ho; Hong, Sung Pil
European radiology
2012Jun ; 22 ( 6 ) :1159-66.
저자 상세정보
Heo, Hyun Mi -
Park, Chan Hyuk -
Lim, Joon Seok -
Lee, Jin Ha -
Kim, Bo Kyung -
Cheon, Jae Hee -
Kim, Tae Il -
Kim, Won Ho -
Hong, Sung Pil -
ABSTRACT
OBJECTIVES: The aim of the present study was to evaluate the role of capsule endoscopy in patients with obscure gastrointestinal bleeding (OGIB) after negative computed tomographic (CT) enterography.

METHODS: We retrospectively included 30 patients with OGIB who received capsule endoscopy after negative CT enterography. The median age of the patients was 60 years, and 60% of patients were male. The median follow-up duration was 8 months. Overt bleeding was 60%, and occult bleeding was 40%.

RESULTS: Based on capsule endoscopy results, a definitive diagnosis was made for 17 patients (57%): ulcer in nine patients (30%), active bleeding with no identifiable cause in five (17%), angiodysplasia in two (7%) and Dieulafoy's lesion in one (3%). Two patients with jejunal ulcers were diagnosed with Crohn's disease. Seven patients (41%) with positive capsule endoscopy received double balloon enteroscopy and two patients (12%) received steroid treatment for Crohn's disease. Patients with overt bleeding, a previous history of bleeding, or who received large amounts of blood transfusions were more likely to show positive capsule endoscopy.

CONCLUSIONS: Capsule endoscopy showed high diagnostic yields in patients with OGIB after negative CT enterography and may help to provide further therapeutic plans for patients with OGIB and negative CT enterography. KEY POINTS: ? CT enterography has been widely used in evaluating obscure gastrointestinal bleeding (OGIB). ? Capsule endoscopy showed high diagnostic yield for OGIB after negative CT enterography. ? Negative CT enterography does not exclude important causes of small bowel bleeding. ? Most lesions missed at CT-enterography are flat and can be detected by capsule endoscopy.
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MESH
Adolescent, Adult, Aged, Aged, 80 and over, Capsule Endoscopy/*methods, Child, False Negative Reactions, Female, Gastrointestinal Hemorrhage/*diagnosis, Humans, Intestine, Small/*pathology/*radiography, Male, Middle Aged, Reproducibility of Results, Sensitivity and Specificity, Tomography, X-Ray Computed/*methods, Young Adult
링크

주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
Capsule endoscopy showed high diagnostic yields in patients with OGIB after negative CT enterography ; a definitive diagnosis was made for 17 patients (57%): ulcer in nine patients (30%), active bleeding with no identifiable cause in five (17%), angiodysplasia in two (7%) and Dieulafoy's lesion in one (3%) through CE.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
DOI
10.1007/s00330-011-2374-1
KCD코드
ICD 03
건강보험코드