REED - Revista Española de Enfermedades Digestivas

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English version

Año 2021 / Volumen 113 / Número 8
Original

Pan-enteric capsule for bleeding high-risk patients. Can we limit endoscopies?

580-584

DOI: 10.17235/reed.2020.7196/2020

Cristina Carretero, César Prieto de Frías, Ramón Angós, Maite Betés, Maite Herráiz, Susana de la Riva, Francisco Zozaya, María Fernández-Calderón, Iago Rodríguez-Lago, Miguel Muñoz Navas,

Resumen

Introduction: obscure gastrointestinal bleeding is defined as bleeding from a source that cannot be identified on upper or lower gastrointestinal endoscopy and capsule endoscopy is the next step in these patients. Some patients may be unsuitable for conventional endoscopy and performing a capsule panendoscopic test as a first line procedure might potentially reduce the number of endoscopies and their subsequent risk. Aim: to analyze our experience with capsule endoscopy in the bleeding setting. Methods: the first 100 panendoscopic capsule procedures performed in our center from August 2011 until December 2016 were retrospectively reviewed. Results: positive findings were observed in 61.2 % of patients; 46.26 % had a previous negative gastroscopy and the capsule detected small bowel lesions in 67.7 % and colonic findings in 80.64 %. Taking into consideration that our population were high-risk patients (mainly because of comorbidities) and that we used up to 45 ml of sodium phosphate, sodium, potassium and creatinine changes were analyzed before and after procedure. The mean “before” values were 140.68, 4.04 and 1.36, respectively. The mean “after” values were 140.28, 3.9 and 1.35 (p = n.s.). According to our findings, no other endoscopic studies would be needed in 64.5 % of patients with negative gastroscopy. According to capsule results, conventional endoscopy could have been avoided in 68.6 % of cases. Conclusion: panendoscopy with a capsule may be useful and safe in bleeding high-risk patients, by selecting those who need therapeutic endoscopy, avoiding up to 68.6 % of diagnostic endoscopies in our series.

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