Negative capsule endoscopy in patients with obscure gastrointestinal bleeding reliable: Recurrence of bleeding on long-term follow-up

Table 1 Characteristics of patients with negative capsule endoscopy

Variables	Total patients	Negative for rebleeding	Rebleeding patients
n	207	173	34
Age (yr)	56.8	56.8	57.1
Sex (M/F)	110/97	70/59	22/12
Obscure-overt bleeding	157	121	2
Obscure-occult bleeding	50	52	32
Median Hb level	8.2	8.8	8.2
OAT/LMWH	36	32	4
Rebleeding time
At 10 mo of follow-up			28
At 24 mo of follow-up			34

OAT: Oral anticoagulant therapy; LMWH: Low molecular weight heparin. M/F: Male/female.

Table 2 Results univariate analysis n (%)

Variables	No rebleeding	Rebleeding	P value	Odds ratio	95%CI	P value
Patients	173	34	-
Sex (M/F)	88/85	22/12	0.1403	1.84471	0.8175-4.16251	0.14031
Age < 65 yr	23 (67.6)	89 (51.4)	0.0838	2.6703	1.1651-6.1202	0.0203
CE indications (melena)	77 (44.5)	26 (76.5)	0.0006	4.7718	1.9739-11.5358	0.0005
Blood transfusion	64 (36.9)	14 (41.2)	0.6463
Hb < 8 g/dL	48 (27.7)	14 (41.2)	0.1189	2.0064	0.8891-4.5274	0.0935
Use of FANS	30 (17.3)	5 (14.7)	0.7085
Oral anticoagulant therapy	13 (7.5)	4 (11.9)	0.4104
Hospitalizations (n)	62 (35.8)	14 (41.2)	0.5559

¹Variables with P < 0.05 are significant. Variables with P < 0.125 entered in the multivariate analysis (logistic regression): (χ² test). Likelihood ratio: 22.1037; P = 0.0002. The younger age (< 65 yr) and the onset of bleeding such as melena are an independent risk factor of rebleeding after negative capsule endoscopy (CE). M/F: Male/female.

Table 3 The final diagnosis and treatment of the 34 negative capsule endoscopy patients with rebleeding

Type of rebleeding	n	Final diagnosis	Treatment
Obscure overt bleeding	2		Surgery
		Extraluminal GIST
		Meckel’s diverticulum
Obscure occult bleeding	32
	13	Causes not found	SR
	5	Myelodisplastyc syndrome	MT
	3	Uterine fibroma	Surgery
	1	Metastatic breast cancer	Surgery + MT
	3	Giardia lamblia infection	MT
	5	Chronic use of NSAID
	2	Erosive gastritis	MT

GIST: Gastrointestinal stromal tumor; SR: Spontaneous resolution; MT: Medical therapy.