Analysis of the Factors that Affect the Diagnostic Yield of Capsule Endoscopy in Patients with Obscure Gastrointestinal Bleeding

Lee, Beom Jae; Chun, Hoon Jai; Koo, Ja Soul; Keum, Bora; Park, Sang Hoon; Kim, Du Rang; Kwon, Yong Dae; Kim, Yong Sik; Jean, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Lee, Sang Woo; Choi, Jai Hyun; Kim, Chang Duck; Ryu, Ho Sang

Abstract

BACKGROUND/AIMS
Capsule endoscopy (CE) has become a valuable modality for the detection of small bowel lesions. The usefulness of CE for obscure gastrointestinal (GI) bleeding has been established with an overall diagnostic yield of 60%. It is unknown whether CE is of equal value in all the patients or of greater benefit in selected groups in Korea. We evaluated the factors that affect the diagnostic yields of CE in patients with obscure GI bleeding.
METHODS
CE was performed in 126 consecutive patients [74 men and 52 women mean age : 52.5 years (25-75 yrs), 23 with active bleeding] with obscure GI bleeding between September 2002 and July 2004. Patients were divided into two groups: those with documented bleeding lesions and those with non specific CE findings. We analyzed the clinical characteristics and other parameters that influenced the diagnostic yields of CE.
RESULTS
A definite or probable cause for obscure GI bleeding was found in 69% (80/116) of the patients. NSAID induced ulcer (16.4%) and angiodysplasia (12.1%) were the most common diagnoses. In patients with active bleeding, the diagnostic yield was significantly greater than that of the patients with occult bleeding (80% vs. 68.3%, p<0.05). However, there was no significant difference in parameters between patients with abnormal CE and those with normal CE in respect to gender, age, previous bleeding history, need for transfusion, cecum imaging, and bowel preparation.
CONCLUSIONS
The diagnostic yield of CE in patients with obscure GI bleeding is 69%. It is significantly higher in patients with active bleeding.