Yıl: 2017 Cilt: 23 Sayı: 1 Sayfa Aralığı: 46 - 50 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?

Öz:
BACKGROUND: The aim of this study was to investigate the efficacy of capsule endoscopy (CE) performed on patients who presented to emergency room with clinically evident gastrointestinal (GI) bleeding from unknown source and were hospitalized for follow-up.METHODS: Total of 38 patients who underwent CE and were followed-up for evaluation of clinically perceptible GI bleeding with no obvious etiology in Istanbul Medical Faculty emergency surgery department were included in the study. Patient data, which were collected between January 1, 2007 and June 1, 2015, were reviewed retrospectively.RESULTS: Of the 38 patients included in this study, 12 (32%) patients were women and 26 (68%) were men. Average age was 55.57 years (range: 20-88 years). Nine patients were using anticoagulants. Ten patients were followed-up in intensive care, and 7 patients underwent angiography. Angioembolization was performed for 1 patient who was diagnosed as having active bleed with CE. Average erythrocyte suspension replacement was 20.7 units. Total of 13 patients underwent surgery for bleeding found with CE. Eleven (34%) patients underwent double-balloon endoscopy, during which 5 patients were treated with cauterization and sclerotherapy was performed on 2. Four (18%) patients died during the study period: 2 died as result of bleeding from unknown source, 1 died of cholangiocarcinoma recurrence, and 1 died of anastomotic leakage. One patient was readmitted to hospital due to recurrence of bleeding. Nineteen (50%) patients were treated successfully based on CE findings. Diagnostic yield of CE was determined to be 78.9%. Average length of hospital stay was 32.68 days (range: 3-153 days).CONCLUSION: CE is an effective tool to detect source of GI bleeding. CE should be first choice of evaluation method for patients admitted to emergency room with obscure overt GI bleeding once radiological imaging determines absence of obstruction.
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Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Katz LB. The role of surgery in occult gastrointestinal bleeding. Semin Gastrointest Dis 1999;10:78-81.
  • 2. American Gastroenterological Association medical position statement: evaluation and management of occult and obscure gastrointestinal bleeding. Gastroenterology 2000;118:197-201.
  • 3. Foutch PG. Angiodysplasia of the gastrointestinal tract. Am J Gastroenterol 1993;88:807-18.
  • 4. American society for gastrointestinal endoscopy. Gastrointestınal endoscopy 2003;58:5.
  • 5. Scapa E, Jacob H, Lewkowicz S, Migdal M, Gat D, Gluckhovski A, et al. Initial experience of wireless-capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology. Am J Gastroenterol 2002;97:2776-9.
  • 6. Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy. Nature 2000;25:405-417.
  • 7. Swain P, Fritscher-Ravens A. Role of video endoscopy in managing small bowel disease. Gut 2004;53:1866-75.
  • 8. Pennazio M, Santucci R, Rondonotti E, Abbiati C, Beccari G, Rossini FP, et al. Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases. Gastroenterology 2004;126:643-53.
  • 9. Bresci G, Parisi G, Bertoni M, Tumino E, Capria A. The role of video capsule endoscopy for evaluating obscure gastrointestinal bleeding: usefulness of early use. J Gastroenterol 2005;40:256-9.
  • 10. Scaglione G, Russo F, Franco MR, Sarracco P, Pietrini L, Sorrentini I. Age and video capsule endoscopy in obscure gastrointestinal bleeding: a prospective study on hospitalized patients. Dig Dis Sci 2011;56:1188-93.
  • 11. Singh V, Alexander JA. The evaluation and management of obscure and occult gastrointestinal bleeding. Abdom Imaging 2009;34:311-9.
  • 12. Lin TN, Su MY, Hsu CM, Lin WP, Chiu CT, Chen PC. Combined use of capsule endoscopy and double-balloon enteroscopy in patients with obscure gastrointestinal bleeding. Chang Gung Med J 2008;31:450-6.
  • 13. Arakawa D, Ohmiya N, Nakamura M, Honda W, Shirai O, Itoh A, et al. Outcome after enteroscopy for patients with obscure GI bleeding: diagnostic comparison between double-balloon endoscopy and videocapsule endoscopy. Gastrointest Endosc 2009;69:866-74.
  • 14. Gerson LB, Fidler JL, Cave DR, Leigthon JA. ACG Clinical guidelines: Diagnosis and management of small bowell bleeding. The American journal of Gastroenterology 2015.
  • 15. Gupta R, Reddy DN. Capsule endoscopy: current status in obscure gastrointestinal bleeding. World J Gastroenterol 2007;13:4551-3.
  • 16. Kameda N, Higuchi K, Shiba M, Machida H, Okazaki H, Yamagami H, et al. A prospective, single-blind trial comparing wireless capsule endoscopy and double-balloon enteroscopy in patients with obscure gastrointestinal bleeding. J Gastroenterol 2008;43:434-40.
  • 17. Lecleire S, Iwanicki-Caron I, Di-Fiore A, Elie C, Alhameedi R, Ramirez S, et al. Yield and impact of emergency capsule enteroscopy in severe obscure-overt gastrointestinal bleeding. Endoscopy 2012;44:337-42.
  • 18. Heo HM, Park CH, Lim JS, Lee JH, Kim BK, Cheon JH, et al. The role of capsule endoscopy after negative CT enterography in patients with obscure gastrointestinal bleeding. Eur Radiol 2012;22:1159-66.
  • 19. Calabrese C, Liguori G, Gionchetti P, Rizzello F, Laureti S, Di Simone MP, et al. Obscure gastrointestinal bleeding: single centre experience of capsule endoscopy. Intern Emerg Med 2013;8:681-7.
APA ÜÇÜNCÜ M, bademler s, ilhan M, GÖK A, Akyuz F, GÜLOĞLU R (2017). What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?. , 46 - 50.
Chicago ÜÇÜNCÜ Muhammed Zübeyr,bademler süleyman,ilhan Mehmet,GÖK Ali Fuat Kaan,Akyuz Filiz,GÜLOĞLU Recep What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?. (2017): 46 - 50.
MLA ÜÇÜNCÜ Muhammed Zübeyr,bademler süleyman,ilhan Mehmet,GÖK Ali Fuat Kaan,Akyuz Filiz,GÜLOĞLU Recep What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?. , 2017, ss.46 - 50.
AMA ÜÇÜNCÜ M,bademler s,ilhan M,GÖK A,Akyuz F,GÜLOĞLU R What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?. . 2017; 46 - 50.
Vancouver ÜÇÜNCÜ M,bademler s,ilhan M,GÖK A,Akyuz F,GÜLOĞLU R What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?. . 2017; 46 - 50.
IEEE ÜÇÜNCÜ M,bademler s,ilhan M,GÖK A,Akyuz F,GÜLOĞLU R "What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?." , ss.46 - 50, 2017.
ISNAD ÜÇÜNCÜ, Muhammed Zübeyr vd. "What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?". (2017), 46-50.
APA ÜÇÜNCÜ M, bademler s, ilhan M, GÖK A, Akyuz F, GÜLOĞLU R (2017). What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?. Ulusal Travma ve Acil Cerrahi Dergisi, 23(1), 46 - 50.
Chicago ÜÇÜNCÜ Muhammed Zübeyr,bademler süleyman,ilhan Mehmet,GÖK Ali Fuat Kaan,Akyuz Filiz,GÜLOĞLU Recep What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?. Ulusal Travma ve Acil Cerrahi Dergisi 23, no.1 (2017): 46 - 50.
MLA ÜÇÜNCÜ Muhammed Zübeyr,bademler süleyman,ilhan Mehmet,GÖK Ali Fuat Kaan,Akyuz Filiz,GÜLOĞLU Recep What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?. Ulusal Travma ve Acil Cerrahi Dergisi, vol.23, no.1, 2017, ss.46 - 50.
AMA ÜÇÜNCÜ M,bademler s,ilhan M,GÖK A,Akyuz F,GÜLOĞLU R What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?. Ulusal Travma ve Acil Cerrahi Dergisi. 2017; 23(1): 46 - 50.
Vancouver ÜÇÜNCÜ M,bademler s,ilhan M,GÖK A,Akyuz F,GÜLOĞLU R What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?. Ulusal Travma ve Acil Cerrahi Dergisi. 2017; 23(1): 46 - 50.
IEEE ÜÇÜNCÜ M,bademler s,ilhan M,GÖK A,Akyuz F,GÜLOĞLU R "What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?." Ulusal Travma ve Acil Cerrahi Dergisi, 23, ss.46 - 50, 2017.
ISNAD ÜÇÜNCÜ, Muhammed Zübeyr vd. "What is the clinical yield of capsule endoscopy in the management of obscure bleeding in emergency service?". Ulusal Travma ve Acil Cerrahi Dergisi 23/1 (2017), 46-50.