Diagnostic Yield of Capsule Endoscopy in Obscure Gastrointestinal Bleeding

Vol. 70, No. 3, 2004

Free Abstract Article (Fulltext) Article (PDF 111 KB)

Original Paper

Diagnostic Yield of Capsule Endoscopy in Obscure Gastrointestinal Bleeding
Zvi Fireman^{a, b}, Shosh Friedman^c

^aDepartment of Gastroenterology, Hillel-Yaffe Medical Center, Hadera,
^bFaculty of Medicine, The Technion, Haifa, and
^cGiven Imaging, Ltd., Yoqneam, Israel

Address of Corresponding Author

Digestion 2004;70:201-206 (DOI: 10.1159/000082834)

Key Words

Gastrointestinal bleeding
Capsule endoscopy
Anemia, iron-deficiency

Abstract

Objectives:Chronic occult blood loss from the gastrointestinal tract is a recognized major cause of iron-deficiency anemia. After conventional investigation of the upper and lower parts of the gastrointestinal tract, the source of bleeding remains unidentified in ~10% of these patients. We evaluated the diagnostic yield of capsule endoscopy from patients enrolled in clinical studies due to persistent or recurrent iron-deficiency anemia. Methods: In this large cohort study, patients with obscure gastrointestinal bleeding were identified in a company-sponsored clinical study (Given Imaging, Ltd.) database which contains data from >50 clinical studies. Information on suitable patients was derived from 31 of them. Each subject swallowed an M2A^® Given Capsule containing a miniature video camera, batteries, a transmitter and an antenna. Recording time was ~8 h. The capsule was excreted naturally in the patient's bowel movement, and the data it transmitted were retrieved and interpreted the next day. Results: 293 patients were studied (135 males, 46.1%, mean age 59.4 ± 16.8 years) whose mean number of bleeding episodes was 4.3 ± 5.5 and mean hemoglobin level was 9.8 ± 2.4 g/dl. The average number of diagnostic procedures per patient prior to the capsule endoscopy study was 5.59. Capsule endoscopy detected definitive findings in 213/293 patients (72%) and findings missed by other diagnostic procedures in 22/293 patients (8%). Neither capsule endoscopy nor the other diagnostic procedures yielded diagnoses in 58/293 patients (20%). Conclusions: Capsule endoscopy has a high diagnostic yield in evaluating patients with obscure gastrointestinal bleeding.

Author Contacts

Zvi Fireman, MD
Gastroenterology Department
Hillel Yaffe Medical Center
PO Box 169, Hadera 38100 (Israel)
Tel. +972 4 6304480, Fax +972 4 6304408, E-Mail fireman@hillel-yaffe.health.gov.il

Article Information

Received: May 27, 2004
Accepted: August 16, 2004
Published online: December 17, 2004
Number of Print Pages : 6
Number of Figures : 0, Number of Tables : 6, Number of References : 42

Medline Abstract (ID 15627766)

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