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• W2920939758 abstract "Introduction: Video capsule endoscopy (VCE) is an important diagnostic tool for evaluation of iron deficiency anemia (IDA) and recent overt GI bleeding (OVGB) when EGD and ileocolonoscopy fail to identify a source lesion. The influence of hemoccult positive stool (HPS) status on these indications is less well known. The aim of this study was to identify if there are significant differences in the diagnostic yield (DY) of VCE for patients with HPS only, IDA only, HPS with IDA, or OVGB. Methods: We reviewed all outpatient VCE studies (interpreted by single reader) performed over a 6-year period (Dec 2011 thru Dec 2017). For cases of obscure GI bleeding, studies were sorted into four main indication groups: HPS, IDA, HPS + IDA, and OVGB. DY for lesions with high potential for GI bleeding (Saurin classification P2 lesions) were calculated for each group and compared. Separate DY comparisons were made for lesions found in any GI tract location (esophagus, stomach, small bowel, or colon) and for small bowel lesions only. VCE studies that were incomplete due to poor prep or slow gastric or small bowel motility were excluded from the analysis. Differences in DY comparisons were considered statistically significant for p-value < 0.05. Results: Of 1054 total VCE studies performed, 840 met inclusion criteria. For the total cohort and each obscure bleeding indication subgroup, table 1 shows sample size, DY for lesions in any location of the GI tract, and DY for small bowel lesions only. As expected, DY for each subgroup was progressively higher based on strength of bleeding indication and was significantly higher for recent overt GI bleeding. For the HPS subgroup, there was a statistically significantly lower DY compared to the remaining cohort for lesions in any GI tract location (p=0.047) and in the small bowel only (p=0.042). For IDA and HPS + IDA, there were no statistically significant differences in DY relative to the remaining cohort (p>0.05 for all comparisons). Conclusion: For all forms of obscure GI bleeding, this retrospective analysis shows that the overall diagnostic yield of VCE for clinically significant bleeding sources was 38.0% for lesions in any location of the GI tract and 29.2% for lesions in the small bowel. When comparing different indication subgroups of obscure-occult bleeding, the DY of HPS only was significantly lower than the remaining subgroups. VCE should continue to be considered in the diagnostic evaluation of OVGB, IDA with HPS and IDA only, but not for HPS only.1157 Figure 1. Diagnostic yield of capsule endoscopy for different indications of obscure GI bleeding" @default.
• W2920939758 created "2019-03-22" @default.
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• W2920939758 date "2018-10-01" @default.
• W2920939758 modified "2023-09-25" @default.
• W2920939758 title "Differences in Diagnostic Yield of Video Capsule Endoscopy Based on Definition of Obscure GI Bleeding" @default.
• W2920939758 doi "https://doi.org/10.14309/00000434-201810001-01157" @default.
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