Could Capsule Endoscopy Be Useful in Detection of Suspected Small Bowel Bleeding and IBD-10 Years of Single Center Experience
Abstract
:1. Introduction
2. Materials and Methods
- (1)
- overt obscure bleeding if they had clinical signs of gastrointestinal bleeding (melena, hematochezia).
- (2)
- occult obscure bleeding if there were no clinical signs of gastrointestinal bleeding in the presence of iron deficiency anemia with a positive fecal occult blood test [7].
3. Results
4. Discussion
4.1. Indications for VCE
4.2. Diagnostic Yield of VCE
4.3. When to Perform VCE-Timing of the Procedure?
4.4. Findings on VCE
4.4.1. Vascular Lesions
4.4.2. Inflammatory Bowel Disease—Crohn’s Disease
4.4.3. Neoplastic Lesions
4.4.4. Celiac Disease
4.4.5. Gastrointestinal Polyposis Syndromes
4.5. Use of VCE in Pediatric Patients
4.6. Follow-Up Strategies
4.7. Complications during VCE
4.8. Limitations of the Procedure
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Overt Bleeding N = 92 | Occult Bleeding N = 106 | Other Indication N = 47 | |
---|---|---|---|
Sex (male) | 52 (56.5%) | 57 (53.7%) | 23 (48.9%) |
Age (mean, age range) | 50 (3–83) | 52 (8–83) | 40 (17–71) |
Past medical history | |||
Hypertension | 18 | 20 | 4 |
Diabetes mellitus | 15 | 8 | 1 |
Chronic obstructive pulmonary disease | 8 | 4 | / |
Chronic renal failure | 10 | 15 | 2 |
Cardiomyopathy | 5 | 6 | / |
Atrial fibrillation | 8 | 10 | / |
Cerebrovascular insult | / | 2 | / |
Liver cirrhosis | / | / | 1 |
IBD | / | / | 2 |
Drugs | |||
Warfarin | 3 | 4 | / |
DOAC | 5 | 6 | / |
Salicilates | 15 | 18 | / |
NSAID | 5 | 6 | 2 |
Duration of symptoms (in months) | 13 (1–72) | 21 (2–108) | 23 (2–84) |
Hemoglobin level prior CE (mean, range g/L) | 95 (60–125) | 98 (72–151) | 110 (85–135) |
Previous red cell blood transfusion (Yes) | 20 | 23 | / |
Number of transfusion prior to CE | 2 (1–3) | 1 (1–2) | / |
Previous hospital admissions due to bleeding (Yes) | 24 | 34 | / |
Number of previous hospitalizations due to bleeding | 1 (1–2) | 2 (1–3) | / |
Indication | Number | P2 Lesions | P1 Lesions | P0 Lesions | p | |
---|---|---|---|---|---|---|
Obscure GI bleeding | Overt | 92 | 45 (48.9%) | 22 (23.9%) | 25 (27.2%) | a p = 0.007 |
Occult | 106 | 32 (30.2%) | 32 (30.2%) | 42 (39.6%) | ||
Other indications | 47 | 18 (38.3%) | 6 (12.8%) | 23 (48.9%) |
P2 Lesions (N = 77) | P1 Lesions (N = 54) | ||
---|---|---|---|
Vascular lesions | 31 (40.3%) | Isolated vascular lesions | 25 (46.3) |
Tumor | 22 (28.6%) | Substenosis | 7 (13%) |
Meckel’s diverticulum | 13 (16.9%) | Tumor | 6 (11.1%) |
Crohn’s disease | 3 (3.8%) | Celiac disease | 3 (5.6%) |
Celiac disease | 3 (3.8%) | Crohn’s disease | 3 (5.6%) |
Erosions | 3 (3.8%) | Erosions | 3 (5.6%) |
Polyp | 1 (1.3%) | Meckel’s diverticulum | 3 (5.6%) |
Colon diverticulosis | 1 (1.3%) | Parasitosis | 1 (1.8%) |
Lymphoid agregates | 1 (1.8%) | ||
Polyp | 1 (1.8%) | ||
Diverticulum | 1 (1.8%) |
Indication for VCE (Clinical Suspicion) | Number | P2 Lesions | P1 Lesions | P0 Lesions |
---|---|---|---|---|
Crohn’s disease | 8 | 2 | 2 | 4 |
Tumors | 7 | 3 | 0 | 4 |
Peutz-Jeghers syndrome | 5 | 4 | 0 | 1 |
Chronic diarrhea | 5 | 2 | 2 | 1 |
FAP | 3 | 2 | 0 | 1 |
Congenital lymphangiectasiae | 1 | 0 | 2 | |
Polyps | 3 | 0 | 0 | 3 |
Von Hippel–Lindau syndrome | 2 | 0 | 0 | 2 |
Abdominal pain | 2 | 1 | 0 | 1 |
Refractory celiac disease | 2 | 1 | 0 | 1 |
Protein-losing enteropathy | 2 | 0 | 2 | 0 |
P2 Lesions (N = 18) | P1 Lesions (N = 6) | ||
---|---|---|---|
Tumor | 5 (27.7%) | T cell lymphoma | 2 (33.2%) |
Peutz–Jeghers sy. | 4 (22.2%) | Meckel’s diverticulum | 1 (16.7%) |
Lymphangiectasie | 2 (11.1%) | Celiac disease | 1 (16.7%) |
FAP | 2 (11.1%) | Crohn’s disease | 1(16.7%) |
Crohn’s disease | 2 (11.1%) | Pouchitis | 1 (16.7%) |
Celiac disease | 1(5.6%) | ||
Portal duodenopathy | 1(5.6%) | ||
Small bowel diverticulosis | 1 (5.6%) |
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Martinov Nestorov, J.; Sokic-Milutinovic, A.; Pavlovic Markovic, A.; Krstic, M. Could Capsule Endoscopy Be Useful in Detection of Suspected Small Bowel Bleeding and IBD-10 Years of Single Center Experience. Diagnostics 2024, 14, 862. https://doi.org/10.3390/diagnostics14090862
Martinov Nestorov J, Sokic-Milutinovic A, Pavlovic Markovic A, Krstic M. Could Capsule Endoscopy Be Useful in Detection of Suspected Small Bowel Bleeding and IBD-10 Years of Single Center Experience. Diagnostics. 2024; 14(9):862. https://doi.org/10.3390/diagnostics14090862
Chicago/Turabian StyleMartinov Nestorov, Jelena, Aleksandra Sokic-Milutinovic, Aleksandra Pavlovic Markovic, and Miodrag Krstic. 2024. "Could Capsule Endoscopy Be Useful in Detection of Suspected Small Bowel Bleeding and IBD-10 Years of Single Center Experience" Diagnostics 14, no. 9: 862. https://doi.org/10.3390/diagnostics14090862