A new panenteric capsule endoscopy-based strategy in patients with melena and a negative upper gastrointestinal endoscopy: a prospective feasibility study
| Autor: | Rosario Arena, S. Gasperoni, Lorenzo Fuccio, Alessandra Tina Garribba, Ilaria Manzi, Omero Triossi, Emanuele Rondonotti, Alessandro Mussetto, Margherita Trebbi |
|---|---|
| Přispěvatelé: | Mussetto A., Arena R., Fuccio L., Trebbi M., Tina Garribba A., Gasperoni S., Manzi I., Triossi O., Rondonotti E. |
| Rok vydání: | 2021 |
| Předmět: |
Enteroscopy
Gastrointestinal bleeding medicine.medical_specialty capsule medicine.medical_treatment Colon cleansing gastrointestinal bleeding Colonoscopy Pilot Projects obscure gastrointestinal bleeding Capsule Endoscopy Endoscopy Gastrointestinal law.invention 03 medical and health sciences 0302 clinical medicine Melena Swallowing Capsule endoscopy law medicine Humans Prospective Studies Aged panenteric capsule endoscopy Hepatology medicine.diagnostic_test Esophagogastroduodenoscopy business.industry Gastroenterology medicine.disease Surgery 030220 oncology & carcinogenesis Feasibility Studies Female 030211 gastroenterology & hepatology medicine.symptom Gastrointestinal Hemorrhage business |
| Zdroj: | European Journal of Gastroenterology & Hepatology. 33:686-690 |
| ISSN: | 0954-691X |
| DOI: | 10.1097/meg.0000000000002114 |
| Popis: | Objective patients presenting with melena and nondiagnostic esophagogastroduodenoscopy are usually investigated with colonoscopy and if negative, with small bowel capsule endoscopy. In this pilot study, we tested feasibility and performance of panenteric capsule endoscopy (PCE) in patients presenting with melena and negative esophagogastroduodenoscopy. Methods Between January and December 2018, consecutive patients presenting with melena, clinically significant bleeding and negative esophagogastroduodenoscopy were invited to undergo PCE by swallowing PillCam Colon 2 (Medtronic Inc., Dublin, Ireland). PCE results, further diagnostic or therapeutic examinations, rebleeding rates at 30 days and 12 months were recorded. Results Out of 128 patients with melena, 23 had negative esophagogastroduodenoscopy. Of them, 12 (8 female, mean age 76 years) underwent PCE, which allowed complete small bowel and colonic evaluation in 12 (100%) and 11 (91.7%) patients, respectively. The small bowel and colon cleansing were adequate in 100 and 83.3%, respectively. No PCE-related complications were observed. The PCE diagnostic yield was 83.3%: significant findings were located in the small bowel, colon or both in 5 (41.7%), 4 (33.3%) and 1 (8.3%) patients, respectively. Device-assisted enteroscopy was performed in 6 (50%) patients. Thirty days and 1 year rebleeding rates were 0 and 18.1%, respectively. Conclusions In this proof-of-concept study, PCE was feasible and safe in patients with melena and negative esophagogastroduodenoscopy, identifying the bleeding site in 83% of patients. PCE lead to small bowel therapeutic interventions in 50% of patients, thus avoiding unnecessary standard colonoscopy. Further large prospective randomized studies investigating this strategy are warranted. |
| Databáze: | OpenAIRE |
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