Goenka MK, Majumder S, Kumar S, Sethy PK, Goenka U. Single center experience of capsule endoscopy in patients with obscure gastrointestinal bleeding. World J Gastroenterol 2011; 17(6): 774-778 [PMID: 21390148 DOI: 10.3748/wjg.v17.i6.774]
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Dr. Mahesh Kumar Goenka, Institute of Gastroenterology, Apollo Gleneagles Hospital, 58 Canal Circular Road, Kolkata-700054, India. email@example.com
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Mahesh Kumar Goenka, Shounak Majumder, Sanjeev Kumar, Pradeepta Kumar Sethy, Usha Goenka, Institute of Gastroenterology, Apollo Gleneagles Hospital, 58 Canal Circular Road, Kolkata-700054, India
Author contributions: Goenka MK and Majumder S were the major contributors to this work; Goenka MK and Majumder S designed the research; Goenka MK interpreted all capsule endoscopy images; Majumder S was responsible for tabulating and analyzing the data, drafting the manuscript, and processing the images; Goenka MK and Majumder S wrote the article; Kumar S, Sethy PK and Goenka U performed a critical scientific review of the article and provided valuable input for modifying parts of the article prior to submission.
Correspondence to: Dr. Mahesh Kumar Goenka, Institute of Gastroenterology, Apollo Gleneagles Hospital, 58 Canal Circular Road, Kolkata-700054, India. firstname.lastname@example.org
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Received: August 5, 2010 Revised: September 13, 2010 Accepted: September 20, 2010 Published online: February 14, 2011
AIM: To identify optimum timing to maximize diagnostic yield by capsule endoscopy (CE) in patients with obscure gastrointestinal bleeding (OGIB).
METHODS: We identified patients who underwent CE at our institution from August 2003 to December 2009. Patient medical records were reviewed to determine type of OGIB (occult, overt), CE results and complications, and timing of CE with respect to onset of bleeding.
RESULTS: Out of 385 patients investigated for OGIB, 284 (74%) had some lesion detected by CE. In 222 patients (58%), definite lesions were detected that could unequivocally explain OGIB. Small bowel ulcer/erosions secondary to Crohn’s disease, tuberculosis or non-steroidal anti-inflammatory agent use were the commonest lesions detected. Patients with overt GI bleeding for < 48 h before CE had the highest diagnostic yield (87%). This was significantly greater (P < 0.05) compared to that in patients with overt bleeding prior to 48 h (68%), as well as those with occult OGIB (59%).
CONCLUSION: We established the importance of early CE in management of OGIB. CE within 48 h of overt bleeding has the greatest potential for lesion detection.