Related Experiment Video
Updated: Aug 18, 2026
Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System
Published on: October 16, 2013
Yield of repeat wireless video capsule endoscopy in patients with obscure gastrointestinal bleeding
Bradford H Jones1, David E Fleischer, Virender K Sharma
1Division of Gastroenterology and Hepatology, Mayo Clinic Scottsdale, Scottsdale, Arizona, USA.
Insights
Repeating capsule endoscopy (CE) for obscure gastrointestinal bleeding (OGIB) is valuable. Repeat CE identifies new findings and changes patient management, especially when initial exams are inconclusive.
Area of Science:
- Gastroenterology
- Medical Imaging
- Diagnostic Procedures
Background:
- Capsule endoscopy (CE) is effective for diagnosing obscure gastrointestinal bleeding (OGIB).
- The utility of repeat CE after a negative or nondiagnostic initial examination remains unclear.
- This study evaluates the reasons for, diagnostic yield of, and impact on management of repeat CE in OGIB patients.
Observation:
- Repeat CE was performed for recurrent bleeding (13 cases) or poor initial visualization (10 cases).
- Seventy-five percent (18/24) of repeat CE studies revealed significant findings, including arteriovenous malformations, gastropathy, erosions, and masses.
- Capsule impaction occurred in one patient.
Findings:
- Repeat CE yielded new diagnoses in 75% of patients with obscure gastrointestinal bleeding.
- These new findings led to altered patient management in 62.5% of cases.
- Common indications for repeat CE included recurrent bleeding and suboptimal initial visualization.
Implications:
- Repeat capsule endoscopy is a valuable tool for patients with persistent obscure gastrointestinal bleeding.
- Consider repeat CE when initial capsule endoscopy is negative or inconclusive to improve diagnostic yield and guide management.
- Repeat CE can significantly impact clinical decision-making and patient outcomes in OGIB.
Purpose:
Capsule endoscopy (CE) has been shown to have a high diagnostic yield in patients with obscure gastrointestinal bleeding (OGIB). It is not known if repeating CE improves diagnostic yield or changes patient management when the initial CE is negative or nondiagnostic. The aims of this study are (1) to understand the reasons for repeat CE, (2) to determine the diagnostic yield of repeat CE, and (3) to establish if findings on repeat CE resulted in a change in patient management.
Methods:
Between August 2001 and October 2003, we performed 391 capsule studies. Of these, 24 were repeat studies in patients with OGIB. We retrospectively reviewed the charts of these 24 patients.
Results:
The reasons for repeat CE were: recurrent gastrointestinal bleeding (13), limited visualization on first exam due to poor prep or blood (10), complication (1) (capsule impaction at cricopharyngeus). Eighteen of 24 (75%) repeat capsule studies revealed additional findings (7 arteriovenous malformations, 2 gastropathy, 2 erosions, 2 masses, 1 ulcer, 2 red spots, 1 linear streak, 1 erythema). These findings led to changes in patient management in 15 of the 24 (62.5%) cases.
Conclusions:
Indications for repeat CE most commonly include recurrent gastrointestinal bleeding and limited visualization on initial study. Repeat CE results in a high yield of new findings that lead to changes in patient management. Repeat CE should be considered in patients with persistent OGIB when the initial study is negative or inconclusive.
Related Concept Videos
01:28Endoscopic Procedures III: Video Capsule Endoscopy
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
01:26Endoscopic Procedures V: ERCP
Patient...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:25Endoscopic Procedures II: Colonoscopy