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Endoscopy
DOI: 10.1055/a-2270-4601
Original article

Pan-intestinal capsule endoscopy as first-line procedure in patients with suspected mid or lower gastrointestinal bleeding

Bruno Rosa 
1   Department of Gastroenterology, Hospital da Senhora da Oliveira, Guimarães, Portugal (Ringgold ID: RIN70893)
2   Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
3   ICVS/3B’s, PT Government Associate Laboratory, Braga, Portugal
,
Tiago Cúrdia Gonçalves
1   Department of Gastroenterology, Hospital da Senhora da Oliveira, Guimarães, Portugal (Ringgold ID: RIN70893)
2   Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
3   ICVS/3B’s, PT Government Associate Laboratory, Braga, Portugal
,
Maria J. Moreira
1   Department of Gastroenterology, Hospital da Senhora da Oliveira, Guimarães, Portugal (Ringgold ID: RIN70893)
2   Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
3   ICVS/3B’s, PT Government Associate Laboratory, Braga, Portugal
,
Francisca Dias de Castro
1   Department of Gastroenterology, Hospital da Senhora da Oliveira, Guimarães, Portugal (Ringgold ID: RIN70893)
2   Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
3   ICVS/3B’s, PT Government Associate Laboratory, Braga, Portugal
,
Bernardo Sousa-Pinto
4   MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
5   CINTESIS, Center for Health Technology and Services Research, University of Porto, Porto, Portugal
,
Mário Dinis-Ribeiro
4   MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
6   RISE@CI-IPO (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Center (Porto.CCC), Porto, Portugal
,
José Cotter
1   Department of Gastroenterology, Hospital da Senhora da Oliveira, Guimarães, Portugal (Ringgold ID: RIN70893)
2   Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal
3   ICVS/3B’s, PT Government Associate Laboratory, Braga, Portugal
› Author Affiliations Clinical Trial: Registration number (trial ID): NCT04782986, Trial registry: ClinicalTrials.gov (http://www.clinicaltrials.gov/), Type of Study: Prospective, single-centre, single-blinded cohort study
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Corrected by:

Correction: Pan-intestinal capsule endoscopy as first-line procedure in patients with suspected mid or lower gastrointestinal bleedingEndoscopy eFirst
DOI: 10.1055/a-2299-6793

Referred to by:

Changing the paradigm of capsule endoscopy: tempting… but no (not yet)Endoscopy eFirst
DOI: 10.1055/a-2304-3160

Abstract

Background Pan-intestinal capsule endoscopy (PCE) evaluates the small bowel and colon noninvasively. This study evaluated diagnostic accuracy and safety of PCE vs. colonoscopy as first-line examination in suspected mid–lower gastrointestinal bleeding (MLGIB).

Methods In this prospective, single-center, single-blinded cohort study, consecutive patients with suspected MLGIB underwent PCE followed by same-day colonoscopy. Diagnostic accuracy for potentially hemorrhagic lesions (PHLs; combined diagnosis by PCE + colonoscopy) and incidence of adverse events were assessed.

Results 100 patients were included (median age 70 [range 18–92] years; 65% female). PHLs were diagnosed in 46 patients, including small-bowel and/or colon angioectasias in 32. PCE correctly identified 54 individuals without PHLs, and 95.7% (44/46) of those with PHLs vs. 50.0% (23/46) for colonoscopy (P<0.01). PHLs were detected by PCE alone in 65.2% (30/46), both examinations in 28.3% (13/46), and colonoscopy alone in 6.5% (3/46). PHLs were diagnosed at the ileocolonic region in 28% of patients, with PCE diagnosing 25/28 cases (89.3%) and colonoscopy diagnosing 23/28 (82.1%; P=0.13). Interventional procedures were performed at colonoscopy in 13/81 patients with iron-deficiency anemia (16.0%) vs. 6/19 patients with overt bleeding (31.6%; P<0.01). No significant adverse events occurred with PCE vs. 2% with colonoscopy.

Conclusions In patients with MLGIB, PCE avoided further invasive procedures in >50% of patients. PCE was safe and more effective than colonoscopy in identifying PHL both in the small bowel and colon. These results support the potential use of PCE as first-line examination in patients with suspected MLGIB.

Supplementary Material



Publication History

Received: 05 November 2023

Accepted after revision: 16 February 2024

Accepted Manuscript online:
16 February 2024

Article published online:
14 March 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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