%0 Journal Article
%T Yield, etiologies and outcomes of capsule endoscopy in Thai patients with obscure gastrointestinal bleeding
%A Supot Pongprasobchai
%A Songla Chitsaeng
%A Tawesak Tanwandee
%A Sathaporn Manatsathit
%J World Journal of Gastrointestinal Endoscopy
%D 2013
%I Baishideng Publishing Group Co. Limited
%R 10.4253/wjge.v5.i3.122
%X AIM: To investigate the yield, etiologies and impact of capsule endoscopy (CE) in Thai patients with obscure gastrointestinal bleeding (OGIB). METHODS: The present study is a retrospective cohort study. All patients with OGIB who underwent CE in Siriraj Hospital, Bangkok, Thailand during 2005-2009 were included in the study. All the patients¡¯ medical records and results of the CE videos were reviewed. CE findings were classified as significant, suspicious/equivocal and negative. Sites of the lesions were located to duodenum, jejunum, jejunoileum, ileum and diffuse lesions by the localization device of the CE. Impact of CE on the patients¡¯ management was defined by any investigation or treatment given to the patients that was more than an iron supplement or blood transfusion. Patients¡¯ outcomes (rebleeding, persistent bleeding, anemia or requirement of blood transfusion) were collected from chart reviews and direct phone interviews with the patients. RESULTS: Overall, there were 103 patients with OGIB included in the study. Mean age of the patients was 64 ¡À 16 years (range 9-88 years) and 57 patients (55%) were male. Types of OGIB were overt in 80 (78%) and occult in 23 patients (22%). The median time interval of CE after onset of OGIB was 10 d (range 1-180 d). The median time of follow-up was 19 mo (range 1-54 mo). Capsules reached caecum in 77 patients (74%) and capsule retention was found in 1 patient (1%). The diagnostic yield of CE revealed significant lesions in 37 patients (36%), suspicious/equivocal lesions in 15 patients (15%) and 51 patients (49%) had negative CE result. Among the significant lesions, the bleeding etiologies were small bowel ulcers in 44%, angiodysplasia in 27%, small bowel tumor in 13%, miscellaneous in 8% and active bleeding without identifiable causes in 8%. Patients with small bowel ulcers were significantly associated with the use of non-steroidal anti-inflammatory drugs (48%, P = 0.034), while patients with small bowel tumors were more commonly female (86%, P = 0.043) compared to the other etiologies. The rate of rebleeding, persistent bleeding or anemia in patients with positive, equivocal and negative CE results were 5%, 0% and 18%, respectively (P = 0.078). All the 9 patients with rebleeding after negative CE were subsequently found to be from hematologic disorders (4), colonic diverticulosis (2), colonic Dieulafoy¡¯s (1), hemorrhoid (1) and hemosuccus pancreaticus (1). Results of CE had a positive impact on the patients¡¯ management in 35% of the patients whose results were positive, but none on the patients whose resul
%K Angiodysplasia
%K Etiology
%K Gastrointestinal Bleeding
%K Obscure
%K Capsule Endoscopy
%K Outcome
%K Small bowel ulcer
%K Wireless
%U http://www.wjgnet.com/1948-5190/full/v5/i3/122.htm