Capsule endoscopy for obscure gastrointestinal bleed in the tropics: A single-center experience on 350 patients.

IF 2 Q3 GASTROENTEROLOGY & HEPATOLOGY

Indian Journal of Gastroenterology Pub Date : 2024-10-01 Epub Date: 2024-03-22 DOI:10.1007/s12664-024-01526-0

Uday C Ghoshal, Piyush Mishra, Akash Mathur, Sai Prathap Reddy, Bushra Fatima, Asha Misra

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引用次数: 0

Abstract

Background: Obscure gastrointestinal bleed (OGIB), now called small bowel bleed (SBB), comprises 5% to 10% of all gastrointestinal (GI) bleed episodes and capsule endoscopy (CE) is a tool for its evaluation. Studies on CE in a large sample of SBB patients from the tropics are limited.

Methods: We did a retrospective analysis of a prospectively maintained database of patients with SBB undergoing CE using PillCam or MiroCam CE.

Results: Of 350 patients (age 52.4 ± 17.4 years; 248 [70.9%] male) undergoing CE, 243 (69.4%) and 107 (30.6%) had overt and occult SBB, respectively. CE detected lesions in 244 (69.7%) patients (single lesion in 172 [49.1%]; multiple in 72 [20.6%]). The single lesions included vascular malformations (52, 14.9%), ulcer/erosion (47, 13.4%), tumor (24, 6.9%), hookworm (19, 5.4%), stricture (15, 4.3%), hemobilia (1, 0.3%) and blood without identifiable lesion (9, 2.6%). Of 72 with multiple lesions, ulcer with stricture was the commonest finding (n = 43, 12.3%). No abnormality was detected in 106 (30.3%) patients. The frequency of lesion detection was comparable among patients with overt and occult SBB (173/243, 71.2% vs. 71/107, 66.3%, respectively; p = 0.4). Younger patients (0 to 39 years) more often had multiple lesions on CE than the older (≥ 40 years) ones (26/76, 34.2% vs. 46/228, 20.2%, respectively; p = 0.001).

Conclusion: CE has a high diagnostic yield in SBB in the tropics, regardless of the type of bleed or of CE brand and the duration of recording. Multiple lesions associated with SBB are commoner among younger (< 40 years) patients.

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在热带地区进行胶囊内镜检查治疗不明显的消化道出血：350名患者的单中心经验。

背景：隐匿性胃肠道出血（OGIB），现称为小肠出血（SBB），占所有胃肠道出血病例的5%至10%，胶囊内镜（CE）是对其进行评估的一种工具。对热带地区大样本 SBB 患者进行胶囊内镜检查的研究非常有限：方法：我们对使用 PillCam 或 MiroCam CE 进行 CE 检查的 SBB 患者的前瞻性数据库进行了回顾性分析：在接受CE检查的350名患者（年龄为52.4 ± 17.4岁；248名[70.9%]男性）中，分别有243名（69.4%）和107名（30.6%）患有显性和隐性SBB。CE在244例（69.7%）患者中发现了病变（单发病变172例[49.1%]；多发病变72例[20.6%]）。单发病变包括血管畸形（52 例，14.9%）、溃疡/糜烂（47 例，13.4%）、肿瘤（24 例，6.9%）、钩虫（19 例，5.4%）、狭窄（15 例，4.3%）、血瘘（1 例，0.3%）和无法确定病变的血液（9 例，2.6%）。在 72 例有多处病变的患者中，最常见的病变是溃疡伴狭窄（43 例，12.3%）。106名患者（30.3%）未发现异常。显性和隐性 SBB 患者发现病变的频率相当（分别为 173/243，71.2% 和 71/107，66.3%；P = 0.4）。与年龄较大（≥40 岁）的患者相比，年轻患者（0 至 39 岁）在 CE 中出现多个病灶的比例更高（分别为 26/76, 34.2% vs. 46/228, 20.2%；p = 0.001）：结论：在热带地区，无论出血类型或CE品牌以及记录时间长短，CE对SBB的诊断率都很高。与 SBB 相关的多发病变在年轻人中更为常见（P=0.001）。

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来源期刊

Indian Journal of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

3.90

自引率

10.00%

发文量

期刊介绍： The Indian Journal of Gastroenterology aims to help doctors everywhere practise better medicine and to influence the debate on gastroenterology. To achieve these aims, we publish original scientific studies, state-of -the-art special articles, reports and papers commenting on the clinical, scientific and public health factors affecting aspects of gastroenterology. We shall be delighted to receive articles for publication in all of these categories and letters commenting on the contents of the Journal or on issues of interest to our readers.