Clin Endosc.  2016 Jan;49(1):16-20. 10.5946/ce.2016.49.1.16.

The Role of Capsule Endoscopy in Patients with Obscure Gastrointestinal Bleeding

• Min YW
• Chang DK

• KMID: 2166543
• DOI: http://doi.org/10.5946/ce.2016.49.1.16

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.

Keyword

Capsule endoscopy; Diagnosis; Obscure gastrointestinal bleeding; Outcome

MeSH Terms

Capsule Endoscopy*
Diagnosis
Double-Balloon Enteroscopy
Hemorrhage*
Humans
Mucous Membrane

Figure

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  Fig. 1. A Kaplan-Meier curve showing rebleeding probability after capsule endoscopy in patients with obscure gastrointestinal bleeding.

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  Fig. 2. Kaplan-Meier curves showing rebleeding probability after capsule endoscopy in patients with obscure gastrointestinal bleeding according to capsulen endoscopy findings.

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