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

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.