Abstract
Introduction: Capsule endoscopy (CE) was introduced in the year 2000 for visualizing the gastrointestinal (GI) tract and since then it has played an important role in the assessment of patients with obscure GI bleeding (OGIB) and unexplained iron deficiency anaemia (IDA). Methods: The aim of this study was to describe the usefulness of CE in the assessment of OGIB and IDA. We analysed the demographical and medical conditions of these patients and the diagnostic yield of CE and its impact on patient management. Results: Of the 22 patients, 12 were male. Mean age was 50.7 (SD=19.6 years, Range= 20-81) years. The majority (n=11) referred were being investigated for unexplained iron deficiency anaemia. Other indications were, OGIB (n=6), melaena (n=4), malabsorption and IDA (n=1) and massive GI bleed (n=1). CE showed no abnormalities in 7, polyps and helminthiasis were identified in 2 patients each. Multiple other pathologies were also identified in the remaining. In 91.3 % (n=21) it provided new information and in 83.3% (n=20) it provided the information sought by the doctor. In 79.2% (n=19) it changed the management. Conclusion: Though the cost of CE is significantly high compared to other GI investigations, the high diagnostic yield and its impact on patient management justified its use. Key words: Anaemia; Obscure gastro intestinal bleeding; Capsule endoscopy. DOI: http://dx.doi.org/10.4038/sljs.v29i1.3578 Sri Lanka Journal of Surgery 2011: 29(1) 23-27
Highlights
Capsule endoscopy (CE) was introduced in the year 2000 for visualizing the gastrointestinal (GI) tract and since it has played an important role in the assessment of patients with obscure GI bleeding (OGIB) and unexplained iron deficiency anaemia (IDA)
Population and sample Twenty two consecutive patients who were referred for CE to the GI Physiology Laboratory of the Department of Surgery, Faculty of Medicine, University of Colombo for CE for the investigation of OGIB or IDA were included in the study
Since the 2 patients who underwent colonic CE underwent small bowel CE, the data given below are for small bowel CE unless otherwise specified
Summary
Capsule endoscopy (CE) was introduced in the year 2000 for visualizing the gastrointestinal (GI) tract and since it has played an important role in the assessment of patients with obscure GI bleeding (OGIB) and unexplained iron deficiency anaemia (IDA). OGIB is defined as recurrent or persistent gastrointestinal (GI) bleeding in the absence of any positive findings at initial upper and lower GI endoscopy [8] This is further divided into 2 groups depending on the presence or absence of overt bleeding; i.e. clinically evident passage of blood from the GI tract (Obscure Overt GI bleeding, OGIB-Overt) or faecal occult blood being positive and/or iron deficiency anaemia in the absence of overt bleeding (Obscure Occult GI bleeding, OGIB-Occult). IDA can be caused by many causes, and GI bleeding is one of the common and more sinister
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