Clinical value of capsule endoscopy in obscure gastrointestinal bleeding

Abstract

Objective Assessed the efficiency of capsule endoscopy in obscure gastrointestinal bleeding （OGIB） diagnosis and the reference value of diagnosis results in further clinical treatment, analyzed how capsule endoscopy results can affect patients＇ prognosis. Methods 307 consecutive patients who under- went capsule endoscopy for OGIB from June 2002 to October 2010 were enrolled. Follow-up data were ob- tained by reviewing medical records, capsule endoscopy database and contacting the patients or their relatives by telephone. We set validation criteria to calculate the capsule endoscopy inspection sensitivity, specificity, positive predictive value, negative predictive value, the accuracy. And by comparing the clinical treatment and prognosis of capsule endoscopy-positive patients with those of capsule endoscopy-negative ones, we ana- lyzed bow capsule endoscopy results can guide clinical treatment and its effect on prognosis. Results Among the patients who perform capsule endoscopy for OGIB, 307 patients follow-up data were available, with a medium follow-up of 52. 0 （range 13 -112, interquartile range 33 -74 ） months. In this study, the diagnostic yield of capsule endoscopy is 65.8% , and the accuracy is 84. 8%. Sensitivity, specificity, posi- tive predictive value and negative predictive value of capsule endoscopy were 81.7% , 91.4% , 95.2% and 70. 5%, respectively. The effective intervention rate of specific treatments in capsule endoscopy-postive pa- tients was 94. 5%, while the total effective intervention rate was 94. 7%. Conclusion Capsule endoscopy for OGIB is an effective and safe method with excellent tolerability as well as high diagnostic yield and accu- racy, able to effectively guide the clinicians to proper diagnosis and treatment, thus greatly improving the prognosis of these patients. Key words: Capsule endoscopes ; Diagnosis ; Early intervention; Prognosis ; Obscure gastro-intestinal bleeding