Usefulness of a novel wired magnetic-assisted capsule endoscopy in stable patients with acute upper gastrointestinal bleeding: A prospective cohort study.

Background and aims: Not all patients with acute upper gastrointestinal (UGI) bleeding need endoscopic intervention. This pilot study aimed to evaluate the potential of a novel wired magnetic-assisted capsule endoscopy (MACE) in identifying the source and cause of bleeding as well as the need for hemostasis and biopsy in stable patients with acute UGI bleeding.

Method: Stable patients with suspected acute UGI bleeding were prospectively enrolled at a referral center to undergo MACE followed by esophagogastroduodenoscopy (EGD). Endpoints included accuracy in identifying the source and cause of bleeding, the need for endoscopic hemostasis or biopsy, and completeness of the examination.

Result: Thirty patients [mean age (range): 64.1 (34-82) years; 73.3 % male] were analyzed, and MACE enabled accurate determination of the need for hemostasis and biopsy in 93.3 % (28/30) and 86.7 % (26/30), respectively. In the 22 patients (73.3 %) where MACE achieved a complete examination, MACE determined the source and cause of bleeding in 15 (68.2 %) and the need for hemostasis or biopsy in all patients. The 7 patients whose bleeding sources were not detected by MACE had erosions/shallow ulcers requiring no intervention. In the 8 patients with incomplete examinations, MACE identified the source of bleeding and need for hemostasis in 6 (75.0 %) and determined the cause of bleeding and need for biopsy in 4 (50.0 %).

Conclusion: Wired MACE demonstrated accuracy in identifying the source and cause of bleeding, as well as the need for hemostasis and biopsy in stable patients with acute UGI bleeding.