Published online Apr 16, 2018. doi: 10.4253/wjge.v10.i4.74
Peer-review started: December 4, 2017
First decision: December 22, 2017
Revised: January 18, 2018
Accepted: March 14, 2018
Article in press: March 15, 2018
Published online: April 16, 2018
An early diagnosis with capsule endoscopy in overt-obscure gastrointestinal bleeding patients can lead to an appropriate specific intervention, better long term-outcomes and reduce unnecessary medical costs. European Society of Gastrointestinal Endoscopy recommends performing capsule endoscopy as soon as possible after the bleeding episode, optimally within 14 d. In this paper we evaluated the impact of the timing of capsule endoscopy in these patients, focusing in an earlier evaluation.
As an earlier diagnosis could lead to an earlier and more effective therapy, the authors ought to evaluate the impact of an earlier capsule evaluation on the therapeutic yield and the rebleeding rate.
To evaluate how the timing of capsule endoscopy (CE) in overt-obscure gastrointestinal bleeding (OGIB) could change management of overt-OGIB and future outcomes.
The diagnostic and therapeutic yield (DY and TY) rebleeding rate, time to rebleed and mortality were calculated and compared according to the timing of capsule endoscopy (≤ 48 h; 48 h-14 d and ≥ 14 d).
Despite a similar diagnostic yield, performing capsule endoscopy within 48 h is associated with greater therapeutic yield, less rebleeding episodes, and a longer rebleeding-free time. This suggests that a more timely approach than the 14 d recommendation in the evaluation of overt-OGIB should be considered.
Performing CE within 48 h from the onset of overt-OGIB is associated with a higher therapeutic yield, a lower rebleeding rate and a longer rebleeding-free time. It raises the question that performing CE sooner than 14 d could be advisable.
Our study has a retrospective design with a small number of patients, so a prospective assessment of this timing of CE in overt-OGIB in a larger population is warranted to confirm these findings and change recommendations.