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DIAGNOSTIC YIELD AND FACTORS ASSOCIATED WITH SIGNIFICANT FINDINGS OF CAPSULE ENDOSCOPY IN OBSCURE GASTROINTESTINAL BLEEDING
P Kamalaporn, G Kandel, G May, P Kortan, N Marcon
Center for Therapeutic Endoscopy and Endoscopic Oncology, St Michael’s Hospital, University of Toronto, Toronto, Ontario
BACKGROUND: Management of obscure gastrointestinal bleeding (OGIB) is a challenge to the physicians. Capsule endoscopy (CE) is the novel modality, that helps physicians to evaluate entire small bowel.
OBJECTIVE: The aims of this prospective cross-sectional study were to show diagnostic yields and factors associated with significant findings of CE from our series.
METHODS: All patients with OGIB, who underwent CE from July 2006 to September 2007, were recruited in this study. All findings of CE were collected and factors associated with significant findings of CE were determined by univariate and multivariate analysis.
RESULTS: Sixty eight patients were evaluated: mean age 61.3 years (±18.2), 28 female, overt bleeding 43 patients, mean HB 103.46(±20.8). CE completely examined entire small bowel in 83.9% (57/68) and showed significant findings in 60.3% (41/68). The common findings were small bowel ulcers 25% (17/68), small bowel angioectasias 22.1% (15/68) and bleeding lesions 13.2% (9/68). Between groups with and without significant findings, there were no significant differences in age, sex, type of bleeding and medication, except for timing of CE after bleeding (p=0.029) and Hb level (p=0.03). By multivariate analysis, timing of CE within 14 days after bleeding, independently associated with significant findings of CE (OR: 9.35; 95%CI: 1.61-54.67, p=0.13).
CONCLUSION: CE gave high diagnostic yields of small bowel study. Small bowel ulcers and small bowel angioectasias were common findings in patients with OGIB. And CE within 14 days was an important factor associated with significant findings.