Capsule endoscopy examination of patients with obscure gastrointestinal bleeding : evaluation of clinical impact

Background : Wireless video capsule endoscopy (WVCE) has been reported to contribute to the diagnostic management of patients with obscure gastrointestinal bleeding (OGB). Never- theless, clinical impact data is lacking. The aim of our study was to determine the clinical outcome of patients undergoing WVCE for OGB. Patients and Methods : 38 patients who were referred for OGB and who underwent WVCE examination were included in this study. A questionnaire was sent to the referring doctors after the capsule investigation. The following items were investigated : the final diagnosis of OGB, treatment applied and clinical outcome. Results : Data was recorded for 26 patients out of 38 (17F, 9M). The mean age was 63 years (range, 21-84). A positive finding was noted in 11 patients. Findings included small bowel lesions in 7 cases and gastroduodenal lesions in 4 cases. As a result of the capsule investigation, specific therapy was administered in 9 patients. Six of the 9 patients treated had no further anemia. Final diagnosis of OGB was in agreement with positive findings of WVCE in all these 11 patients. Among the 15 patients with a negative WVCE, 9 had a digestive lesion (3 small bowel lesions) as a final diagnosis. Conclusion : Patients with a positive result at WVCE had fur- ther intervention in 82% and were successfully treated in 67% of cases. We had no false positive results in this study, which suggest a high positive predictive value of WVCE. Moreover, negative WVCE had also an indirect clinical impact. (Acta gastroenterol. belg., 2005, 68, 10-14).