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Vargas-Potes CJ, Zapata-Vásquez IL, Rojas-Rojas NE, Rojas-Rodríguez CA. Clinical impact of capsule endoscopy on patients with suspected small bowel bleeding: Experience at a highly specialized hospital in Colombia. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2024; 89:222-231. [PMID: 37833138 DOI: 10.1016/j.rgmxen.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/25/2023] [Indexed: 10/15/2023]
Abstract
INTRODUCTION AND AIMS Capsule endoscopy is part of the diagnostic approach to patients with suspected small bowel bleeding and data on its clinical impact are still limited in developing countries. The primary aim of the present study was to determine its impact on subsequent diagnostic and therapeutic decisions. MATERIAL AND METHODS A retrospective study was conducted that included all the patients that underwent capsule endoscopy with the PillCam™ SB 3 Capsule system due to suspected small bowel bleeding treated at the Hospital Universitario Fundación Valle del Lili between January 2011 and December 2020. RESULTS A total of 158 patients met the inclusion criteria. Mean patient age was 63 years (interquartile range [IQR], 52-74), 53.6% of the patients were women, and high blood pressure was the most frequent comorbidity (43.7%). The main indication was overt bleeding (58.2%). Of all the capsule endoscopies carried out, 63.9% showed lesions that were potentially responsible for bleeding. Medical or surgical treatment was indicated in 63.3% of the case total. Rebleeding at 6 months occurred in 15 patients and there were 2 deaths due to gastrointestinal bleeding at 6 months. CONCLUSIONS Capsule endoscopy has a high impact on patients with suspected small bowel bleeding, with respect to clinical decision-making, as well as rebleeding, hospitalization, and mortality outcomes. The positivity rate of lesions potentially responsible for bleeding was similar to that reported in developed countries.
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Affiliation(s)
- C J Vargas-Potes
- Departamento de Medicina Interna, Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Valle del Cauca, Colombia.
| | - I L Zapata-Vásquez
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - N E Rojas-Rojas
- Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - C A Rojas-Rodríguez
- Departamento de Gastroenterología, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
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Singla N, Inavolu P, Jagtap N, Singh AP, Kalapala R, Memon SF, Katukuri GR, Pal P, Nabi Z, Ramchandani M, Lakhtakia S, Banerjee R, Reddy PM, Tandan M, Reddy N. Small Bowel Capsule Endoscopy: Experience from a single large tertiary care centre. Endosc Int Open 2023; 11:E623-E628. [PMID: 37614640 PMCID: PMC10442921 DOI: 10.1055/a-2096-2453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 12/20/2022] [Indexed: 08/25/2023] Open
Abstract
Background and study aims Capsule endoscopy (CE) has transformed examination of the small bowel (SB), once considered a dark continent. The present study aimed to describe the indications, diagnostic yield, practical issues and complications of CE in one of the largest tertiary center in India. Patients and methods This retrospective analysis from a prospectively maintained database, conducted from January 2013 to June 2021 included 1155 CEs performed during this period. Patient medical records were reviewed for indications, results, and complications of CE. Results A total of 1154 patients (809 males and 345 females), mean age 53 years (range 6-87 years), one capsule got stuck in the esophagus, were included in the study. Active SB bleeding had no effect on SB transit time (324.7±161 minutes, n = 137 patients with active bleed vs 310.6±166.9 minutes, n = 1017 patients without active bleed; P = 0.35). The indication and diagnostic yield (DY) of CE were potential overt SB bleed (68.6% & 43.9%), potential occult SB bleed (8.2% and 40%), chronic diarrhea (7.9% and 28.4%), abdominal pain (6.5% and 21.3%), anemia (5.9% and 57.9%), and suspected/known case of Crohn's disease (2.3% & 56.5%) respectively. The DY for patients with age ≥60 years was similar to those with age < 60 years (61.9% vs. 51.8% respectively; P = 0.4). 21 patients (1.8%) had capsule retention of which six (0.5%) had to be referred for surgery. Conclusions CE is a safe and effective investigation with ever increasing range of indications. Potential SB bleed remains the most common indication for CE with high detection rate.
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Affiliation(s)
- Neeraj Singla
- Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Pradev Inavolu
- Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Nitin Jagtap
- Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | | | - Rakesh Kalapala
- Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | | | | | - Partha Pal
- Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Zaheer Nabi
- Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Mohan Ramchandani
- Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Sundeep Lakhtakia
- Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Rupa Banerjee
- Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | | | - Manu Tandan
- Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Nageshwar Reddy
- Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
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Furner M, Nagel R, Pinidiyapathirage J. Video capsule endoscopy in patients with iron deficiency anaemia: experience at a regional Australian service. BMC Res Notes 2022; 15:160. [PMID: 35538582 PMCID: PMC9092797 DOI: 10.1186/s13104-022-06053-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/26/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The objective of this study was to identify the diagnostic performance of video capsule endoscopy (VCE) among patients presenting with iron deficiency anaemia (IDA) and negative bidirectional endoscopy to a gasteroendoscopy practice in regional Australia. The secondary objectives were to identify the distribution of findings and factors predictive of positive findings in a regional setting. RESULTS In total 123 procedures were included in the study. Mean age of the patients was 67.9 years. Females made up 60.2% (n = 74) of the study population. Mean haemoglobin and ferritin levels were 93.3 g/L and 11.9 ug/L, respectively. Positive findings were present in 67 procedures (54.5%) with the most frequent finding being small bowel angiodysplasia (53.7%, n = 36/67), followed by ulceration/significant erosion (26.8%, n = 18/67), fresh blood (20.8%, n = 14/67) and tumour/polyp (16.4%, n = 11/67). Haemoglobin level was the only variable associated with positive findings (p = 0.005) in the study population. Of the procedures reporting positive findings outside the small bowel, the majority (80%) were within reach of conventional upper endoscopy and may have implications for future practice, particularly when allocating health resources in a rural setting.
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Affiliation(s)
| | - Robyn Nagel
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4222 Australia
| | - Janani Pinidiyapathirage
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4222 Australia
- Rural Medical Education Australia, Toowoomba, QLD 4222 Australia
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