Clinical Trials Study
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World J Gastroenterol. Jul 7, 2014; 20(25): 8221-8228
Published online Jul 7, 2014. doi: 10.3748/wjg.v20.i25.8221
Comparison of a novel bedside portable endoscopy device with nasogastric aspiration for identifying upper gastrointestinal bleeding
Jong Hwan Choi, Jae Hyuk Choi, Yoo Jin Lee, Hyung Ki Lee, Wang Yong Choi, Eun Soo Kim, Kyung Sik Park, Kwang Bum Cho, Byoung Kuk Jang, Woo Jin Chung, Jae Seok Hwang
Jong Hwan Choi, Jae Hyuk Choi, Yoo Jin Lee, Hyung Ki Lee, Wang Yong Choi, Eun Soo Kim, Kyung Sik Park, Kwang Bum Cho, Byoung Kuk Jang, Woo Jin Chung, Jae Seok Hwang, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu 700-712, South Korea
Author contributions: Kim ES designed research; Lee YJ, Cho KB, Jang BK, Choi JH, Lee HK and Choi WY performed research; Chung WJ, Hwang JS and Park KS analyzed data; Choi JH wrote the paper.
Supported by Grant of the Korea Healthcare technology RD Project, Ministry of Health and Welfare, Republic of Korea No. A102065
Correspondence to: Eun Soo Kim, MD, PhD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keimyung University School of Medicine, 194 Dongsan-dong, Jung-gu, Daegu 700-712, South Korea. dandy813@hanmail.net
Telephone: +82-53-2508096 Fax: +82-53-2507088
Received: January 26, 2014
Revised: March 16, 2014
Accepted: April 15, 2014
Published online: July 7, 2014
Abstract

AIM: To compare outcomes using the novel portable endoscopy with that of nasogastric (NG) aspiration in patients with gastrointestinal bleeding.

METHODS: Patients who underwent NG aspiration for the evaluation of upper gastrointestinal (UGI) bleeding were eligible for the study. After NG aspiration, we performed the portable endoscopy to identify bleeding evidence in the UGI tract. Then, all patients underwent conventional esophagogastroduodenoscopy as the gold-standard test. The sensitivity, specificity, and accuracy of the portable endoscopy for confirming UGI bleeding were compared with those of NG aspiration.

RESULTS: In total, 129 patients who had GI bleeding signs or symptoms were included in the study (age 64.46 ± 13.79, 91 males). The UGI tract (esophagus, stomach, and duodenum) was the most common site of bleeding (81, 62.8%) and the cause of bleeding was not identified in 12 patients (9.3%). Specificity for identifying UGI bleeding was higher with the portable endoscopy than NG aspiration (85.4% vs 68.8%, P = 0.008) while accuracy was comparable. The accuracy of the portable endoscopy was significantly higher than that of NG in the subgroup analysis of patients with esophageal bleeding (88.2% vs 75%, P = 0.004). Food material could be detected more readily by the portable endoscopy than NG tube aspiration (20.9% vs 9.3%, P = 0.014). No serious adverse effect was observed during the portable endoscopy.

CONCLUSION: The portable endoscopy was not superior to NG aspiration for confirming UGI bleeding site. However, this novel portable endoscopy device might provide a benefit over NG aspiration in patients with esophageal bleeding.

Keywords: Endoscopy, Gastrointestinal bleeding, Nasogastric aspiration

Core tip: Although nasogastric (NG) tube aspiration is recommended for the potential benefit of risk stratification in upper gastrointestinal (UGI) bleeding, its clinical usefulness is still debatable. Recently, a novel bedside portable endoscopy device (EG scan, IntroMedic Co., Ltd., Seoul, Korea) has been developed to evaluate the esophagogastroduodenal area with high convenience and notable accessibility compared with conventional endoscopy. As far as we know, this is the first study to evaluate the clinical outcomes of this device compared with NG tube aspiration in UGI bleeding identification. We found that EG scan might offer benefits over NG aspiration in patients with esophageal bleeding.