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European Radiology
Published in: European Radiology 6/2012

01-06-2012 | Computed Tomography

The role of capsule endoscopy after negative CT enterography in patients with obscure gastrointestinal bleeding

Authors: Hyun Mi Heo, Chan Hyuk Park, Joon Seok Lim, Jin Ha Lee, Bo Kyung Kim, Jae Hee Cheon, Tae Il Kim, Won Ho Kim, Sung Pil Hong

Published in: European Radiology | Issue 6/2012

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Abstract

Objectives

The aim of the present study was to evaluate the role of capsule endoscopy in patients with obscure gastrointestinal bleeding (OGIB) after negative computed tomographic (CT) enterography.

Methods

We retrospectively included 30 patients with OGIB who received capsule endoscopy after negative CT enterography. The median age of the patients was 60 years, and 60% of patients were male. The median follow-up duration was 8 months. Overt bleeding was 60%, and occult bleeding was 40%.

Results

Based on capsule endoscopy results, a definitive diagnosis was made for 17 patients (57%): ulcer in nine patients (30%), active bleeding with no identifiable cause in five (17%), angiodysplasia in two (7%) and Dieulafoy’s lesion in one (3%). Two patients with jejunal ulcers were diagnosed with Crohn’s disease. Seven patients (41%) with positive capsule endoscopy received double balloon enteroscopy and two patients (12%) received steroid treatment for Crohn’s disease. Patients with overt bleeding, a previous history of bleeding, or who received large amounts of blood transfusions were more likely to show positive capsule endoscopy.

Conclusions

Capsule endoscopy showed high diagnostic yields in patients with OGIB after negative CT enterography and may help to provide further therapeutic plans for patients with OGIB and negative CT enterography.

Key Points

• CT enterography has been widely used in evaluating obscure gastrointestinal bleeding (OGIB).
• Capsule endoscopy showed high diagnostic yield for OGIB after negative CT enterography.
• Negative CT enterography does not exclude important causes of small bowel bleeding.
• Most lesions missed at CT-enterography are flat and can be detected by capsule endoscopy.
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Metadata
Title
The role of capsule endoscopy after negative CT enterography in patients with obscure gastrointestinal bleeding
Authors
Hyun Mi Heo
Chan Hyuk Park
Joon Seok Lim
Jin Ha Lee
Bo Kyung Kim
Jae Hee Cheon
Tae Il Kim
Won Ho Kim
Sung Pil Hong
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
European Radiology / Issue 6/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2374-1

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