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Roles of Capsule Endoscopy and Single-Balloon Enteroscopy in Diagnosing Unexplained Gastrointestinal Bleeding
Shohei Ooka1, Kiyonori Kobayashi1, Kana Kawagishi1
1Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan.
Insights
Single balloon-assisted enteroscopy (SBE) offers higher diagnostic yields for obscure gastrointestinal bleeding (OGIB) than capsule endoscopy (CE). SBE is particularly effective for overt and ongoing bleeding cases, enabling simultaneous diagnosis and treatment.
Area of Science:
- Gastroenterology
- Endoscopy
- Diagnostic Medicine
Background:
- Obscure gastrointestinal bleeding (OGIB) diagnosis relies on varying algorithms for capsule endoscopy (CE) and balloon-assisted enteroscopy (BE).
- Appropriate selection criteria for CE and single balloon-assisted enteroscopy (SBE) in OGIB patients require further clarification.
Purpose of the Study:
- To compare the diagnostic performance of CE and BE in identifying OGIB sources.
- To establish appropriate selection criteria for CE and SBE based on patient conditions.
Main Methods:
- Retrospective analysis of 194 patients undergoing CE and/or BE.
- Examination of positive finding rates, bleeding details, and hemostasis methods.
Main Results:
- SBE showed a significantly higher positive finding rate (73.6%) compared to CE (47.5%).
- Both modalities performed better in overt than occult bleeding cases.
- Ongoing bleeding cases had higher positive findings with SBE than previous bleeding cases.
Conclusions:
- Both CE and SBE are valuable tools for diagnosing OGIB.
- SBE is recommended for overt and ongoing bleeding due to its ability to perform simultaneous diagnosis and treatment.
Background/Aims:
The diagnostic algorithms used for selecting patients with obscure gastrointestinal bleeding (OGIB) for capsule endoscopy (CE) or balloon-assisted enteroscopy (BE) vary among facilities. We aimed to demonstrate the appropriate selection criteria of CE and single balloon-assisted enteroscopy (SBE) for patients with OGIB according to their conditions, by retrospectively comparing the diagnostic performances of CE and BE for detecting the source of the OGIB.
Methods:
We investigated 194 patients who underwent CE and/or BE. The rate of positive findings, details of the findings, accidental symptoms, and hemostasis methods were examined and analyzed.
Results:
CE and SBE were performed in 103 and 91 patients, respectively, and 26 patients underwent both examinations. The rate of positive findings was significantly higher with SBE (73.6%) than with CE (47.5%, p<0.01). The rate of positive findings was higher in overt bleeding cases than in occult bleeding cases for both BE and SBE. Among the overt bleeding cases, the rate was significantly higher in ongoing bleeding cases than in previous bleeding cases.
Conclusions:
Both CE and SBE are useful to diagnose OGIB. For overt bleeding cases and ongoing bleeding cases, SBE may be more appropriate than CE because endoscopic diagnosis and treatment can be completed simultaneously.
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