NEW YORK (Reuters Health), Apr 16 - Capsule endoscopy is more effective than computed tomographic (CT) or standard angiography for the diagnosis of obscure gastrointestinal bleeding, Spanish researchers report in the April issue of the American Journal of Gastroenterology.
As lead researcher Dr. Esteve Saperas told Reuters Health, "Capsule endoscopy is superior to push enteroscopy and small-bowel barium radiography for the diagnosis of obscure gastrointestinal bleeding. We have now shown its superiority over angiographic modalities."
Dr. Saperas and colleagues at University Hospital Vall d'Hebron, Barcelona, studied 28 patients with obscure gastrointestinal bleeding, 25 of whom were prospectively evaluated with CT or standard mesenteric angiography as well as capsule endoscopy. Two patients were unable to undergo angiography because of renal failure and the other patient was allergic to the contrast medium.
Capsule endoscopy identified a source of bleeding in 72% of patients compared to 56% for standard angiography and 24% with CT angiography. In addition, the capsule approach identified all of the patients diagnosed via CT and 86% of those in whom standard angiography provided a diagnosis.
Furthermore, capsule endoscopy was positive in 12 of 19 patients who were negative on CT and six of 11 who were negative on standard angiography.
"Our results indicate that capsule endoscopy detects more lesions than CT or standard mesenteric angiography," concluded Dr. Saperas."
"Moreover," he added, "capsule endoscopy was able to diagnose more than half of cases negative on CT or standard angiography. Thus, capsule endoscopy should be used first after a negative upper endoscopy and colonoscopy, making unnecessary an invasive angiographic procedure in most cases."
By David Douglas
Last Updated: 2007-04-16 12:01:07 -0400 (Reuters Health)
Am J Gastroenterol 2007;102:731-737.
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