Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 7, 2009; 15(45): 5740-5745
Published online Dec 7, 2009. doi: 10.3748/wjg.15.5740
Single-center experience of 309 consecutive patients with obscure gastrointestinal bleeding
Bing-Ling Zhang, You-Hong Fang, Chun-Xiao Chen, You-Ming Li, Zun Xiang
Bing-Ling Zhang, Chun-Xiao Chen, You-Ming Li, Zun Xiang, Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
You-Hong Fang, The Children’s Hospital, College of Medicine, Zhejiang University, 57 Zhugan Lane, Yanan Road, Hangzhou 310003, Zhejiang Province, China
Author contributions: Zhang BL designed the study and revised the article; Fang YH collected, analyzed the data and drafted the article; Chen CX, Li YM and Xiang Z revised the article.
Supported by Science and Technology Fund, Department of Education, Zhejiang Province, China, No. 20070230
Correspondence to: Dr. Zun Xiang, Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China. xianghr@hotmail.com
Telephone: +86-571-87236333 Fax: +86-571-87236677
Received: September 9, 2009
Revised: October 10, 2009
Accepted: October 17, 2009
Published online: December 7, 2009
Abstract

AIM: To investigate the diagnostic yield of capsule endoscopy (CE) in patients with obscure gastrointestinal bleeding (OGIB), and to determine whether the yield was affected by different bleeding status.

METHODS: Three hundred and nine consecutive patients (all with recent negative gastric and colonic endoscopy results) were investigated with CE; 49 cases with massive bleeding and 260 cases with chronic recurrent overt bleeding. Data regarding OGIB were obtained by retrospective chart review and review of an internal database of CE findings.

RESULTS: Visualization of the entire small intestine was achieved in 81.88% (253/309) of cases. Clinically positive findings occurred in 53.72% (166/309) of cases. The positivity of the massive bleeding group was slightly higher than that of the chronic recurrent overt bleeding group but there was no significant difference (59.18% vs 52.69%, P > 0.05) between the two groups. Small intestinal tumors were the most common finding in the entire cohort, these accounted for 30% of clinically significant lesions. In the chronic recurrent overt bleeding group angioectasia incidence reached more than 29%, while in the massive bleeding group, small intestinal tumors were the most common finding at an incidence of over 51%. Increasing patient age was associated with positive diagnostic yield of CE and the findings of OGIB were different according to age range. Four cases were compromised due to the capsule remaining in the stomach during the entire test, and another patient underwent emergency surgery for massive bleeding. Therefore, the complication rate was 1.3%.

CONCLUSION: In this study CE was proven to be a safe, comfortable, and effective procedure, with a high rate of accuracy for diagnosing OGIB.

Keywords: Obscure gastrointestinal bleeding; Capsule endoscopy; Massive bleeding; Chronic recurrent overt occult bleeding