Capsule Endoscopy in Patients with Obscure Gastrointestinal Bleeding

Abstract

The diagnosis of the source of bleeding in patients with obscure digestive bleeding has considerably improved, with a significant influence on the outcome for patients, since the introduction of capsule endoscopy - as shown by numerous studies reporting a higher diagnostic yield with capsule endoscopy in comparison with push enteroscopy and by our recent study [1], on which Dalla Valle et al. have commented [2]. The issue of lesions missed during previous endoscopic examinations was been identified even before the introduction of capsule endoscopy, with several studies on push enteroscopy showing that some 25 % of the lesions detected by push enteroscopy were within the range of a routine esophagogastroduodenoscopy [3] [4]. In the lower gastrointestinal tract, retrograde ileoscopy had a low diagnostic yield and was abandoned by most clinical teams, who limited the exploration to the terminal ileum during colonoscopy [5].