Lower Endoscopic Diagnostic Yields Observed in Non-hematemesis Gastrointestinal Bleeding Patients

Area of Science:

• Gastroenterology
• Medical Diagnostics

Background:

• Locating the source of gastrointestinal bleeding (GIB) presents diagnostic challenges, particularly in patients without hematemesis (vomiting blood).
• Patients experiencing GIB without hematemesis often have delayed diagnoses compared to those who do present with hematemesis.

Purpose of the Study:

• To compare the diagnostic yields of endoscopic procedures in patients with and without hematemesis.
• To evaluate the time to diagnosis and the number of procedures required for each patient group.

Main Methods:

• A retrospective analysis of 343 gastrointestinal bleeding patients admitted to a tertiary care emergency department over 12 months.
• Data collected included presenting symptoms, diagnostic lesions, procedure types, diagnostic yields, and time to diagnosis for both hematemesis and non-hematemesis groups.

Main Results:

• Non-hematemesis GIB patients required significantly longer diagnosis times (30.0 hours vs. 15.6 hours) and had lower initial diagnostic yields (53% vs. 71%) compared to hematemesis patients.
• A higher proportion of non-hematemesis patients (25%) needed multiple procedures versus hematemesis patients (10%).
• Video capsule endoscopy showed a high diagnostic yield (79%) in the non-hematemesis group.

Conclusions:

• Non-hematemesis GIB patients experience diagnostic delays and undergo more non-diagnostic tests.
• Video capsule endoscopy demonstrates significant potential for diagnosing non-hematemesis GIB and warrants further research.