CAPSULE ENDOSCOPY IN OBSCURE GI BLEED CASES: EXPERIENCE FROM SINGLE CENTRE

Abstract

Background: Capsule Endoscopy has a pivotal role in dening small bowel lesions causing overt or obscure GI bleed. The aim of our study was to study the efcacy of capsule endoscopy in diagnosing lesions causing obscure GI bleed and also to dene the common causes. 34 serial patients with obscure GI Bleed Materials and methods: underwent capsule endoscopy over a period of 18 months following normal upper GI endoscopy, normal ileocolonoscopy and normal CT enterography. 30 patients (88.2%) were Results: males and 4 (11.8%) were females. Age of presentation ranged from 14 to 86 years with median age of 43.5 years and mean age of 46.4 years. Comorbidities encountered were Coronary Artery Disease (5 patients, 14.7%), Hypertension (8 patients, 23.5%) and Diabetes Mellitus (2 patients, 5.8%). 5 patients (14.7%) were on Aspirin, 3 patients (8.8%) were on Clopidogrel, 3 patients (8.8%) were on both Aspirin and Clopidogrel and 2 patients (5.8%) were on Oral Anticoagulants (OACs). Presenting complaints were melena in 18 patients (53.1%), haematochezia in 7 patients (21.9%), hematemesis in 3 patients (8.8%), and occult blood loss only was seen in 6 patients (17.6%). Duration of symptoms ranged from 2 days to 14 years with a median of 3 months and mean of 20.4 months. 12 patients (37.5%) presented with a duration of more than 1 year while 10 patients (31.2%) presented with a duration of less than 1 month. Minimum haemoglobin ranged from 3.8 to 13 g/dl with median of 7 g/dl and mean of 7.14g/dl. Capsule endoscopy was positive in 26 patients 76.5%) and negative in 8 patients (23.5%). Telangiectasia were seen in 10 patients (29.4%), ulcers and/or erosions were seen in 5 patients (14.7%), inammatory bowel disease in 3 patients (8.8%) and worms in 1 patient (2.9%). Active bleed with no identiable lesion was seen in 4 patients (11.8%). WCE has high Conclusion: diagnostic yield, is relatively safe and is an important diagnostic tool for OGIB. Small bowel telangiectasia, Ulcers/erosions, Crohn's disease and tumours continue to be commonly recognized causes of OGIB in developing countries like India.