Negative capsule endoscopy without subsequent enteroscopy does not predict lower long-term rebleeding rates in patients with obscure GI bleeding

Jae Jun Park, Jae Hee Cheon, Hee Man Kim, Hyeun Sung Park, Chang Mo Moon, Jin Ha Lee, Sung Pil Hong, Tae Il Kim, Won Ho Kim

Research output: Contribution to journalArticle

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Abstract

Background: Capsule endoscopy (CE) is now widely accepted as a first-line diagnostic modality for obscure GI bleeding (OGIB). However, the clinical implications of negative results of CE studies remain unclear. Objective: To investigate long-term (>1 year) outcomes for patients undergoing CE for OGIB and to identify risk factors associated with rebleeding. Design and Setting: Retrospective study in a tertiary care hospital. Methods: A total of 57 consecutive patients who had undergone CE for OGIB were enrolled and their pre- and post-CE clinical data were collected. Specific treatments were defined as treatments directly aimed at presumed bleeding causes including hemostasis and disease-specific medical therapy, whereas nonspecific treatments were defined as symptomatic treatments for anemia. Results: Of the 57 patients, the indication for CE was obscure-overt bleeding in 46 patients and obscure-occult bleeding in 11 patients. Among 51 patients for whom long-term data were available, significant (P2) lesions were found in 23 (45.1%) patients. The overall rebleeding rate was 35.3% during a median follow-up duration of 31.7 months (range 12.8-58.0 months). There was no statistically significant difference in the cumulative rebleeding rate between patients with positive and negative CE results (34.8% vs 35.7%, respectively; P = .989). However, specific treatments after CE (hazard ratio, 0.111; 95% CI, 0.013-0.980; P = .043) significantly decreased rebleeding. Limitations: Small number of patients, retrospective study design. Conclusions: The rebleeding rate for patients with OGIB and negative CE results was substantial, indicating that these patients should be closely observed. However, specific treatment after CE significantly reduced the incidence of recurrent bleeding.

Original languageEnglish
Pages (from-to)990-997
Number of pages8
JournalGastrointestinal Endoscopy
Volume71
Issue number6
DOIs
Publication statusPublished - 2010 May 1

Fingerprint

Capsule Endoscopy
Hemorrhage
Therapeutics
Retrospective Studies
Tertiary Healthcare
Hemostasis
Tertiary Care Centers
Anemia

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Park, Jae Jun ; Cheon, Jae Hee ; Kim, Hee Man ; Park, Hyeun Sung ; Moon, Chang Mo ; Lee, Jin Ha ; Hong, Sung Pil ; Kim, Tae Il ; Kim, Won Ho. / Negative capsule endoscopy without subsequent enteroscopy does not predict lower long-term rebleeding rates in patients with obscure GI bleeding. In: Gastrointestinal Endoscopy. 2010 ; Vol. 71, No. 6. pp. 990-997.
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abstract = "Background: Capsule endoscopy (CE) is now widely accepted as a first-line diagnostic modality for obscure GI bleeding (OGIB). However, the clinical implications of negative results of CE studies remain unclear. Objective: To investigate long-term (>1 year) outcomes for patients undergoing CE for OGIB and to identify risk factors associated with rebleeding. Design and Setting: Retrospective study in a tertiary care hospital. Methods: A total of 57 consecutive patients who had undergone CE for OGIB were enrolled and their pre- and post-CE clinical data were collected. Specific treatments were defined as treatments directly aimed at presumed bleeding causes including hemostasis and disease-specific medical therapy, whereas nonspecific treatments were defined as symptomatic treatments for anemia. Results: Of the 57 patients, the indication for CE was obscure-overt bleeding in 46 patients and obscure-occult bleeding in 11 patients. Among 51 patients for whom long-term data were available, significant (P2) lesions were found in 23 (45.1{\%}) patients. The overall rebleeding rate was 35.3{\%} during a median follow-up duration of 31.7 months (range 12.8-58.0 months). There was no statistically significant difference in the cumulative rebleeding rate between patients with positive and negative CE results (34.8{\%} vs 35.7{\%}, respectively; P = .989). However, specific treatments after CE (hazard ratio, 0.111; 95{\%} CI, 0.013-0.980; P = .043) significantly decreased rebleeding. Limitations: Small number of patients, retrospective study design. Conclusions: The rebleeding rate for patients with OGIB and negative CE results was substantial, indicating that these patients should be closely observed. However, specific treatment after CE significantly reduced the incidence of recurrent bleeding.",
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Negative capsule endoscopy without subsequent enteroscopy does not predict lower long-term rebleeding rates in patients with obscure GI bleeding. / Park, Jae Jun; Cheon, Jae Hee; Kim, Hee Man; Park, Hyeun Sung; Moon, Chang Mo; Lee, Jin Ha; Hong, Sung Pil; Kim, Tae Il; Kim, Won Ho.

In: Gastrointestinal Endoscopy, Vol. 71, No. 6, 01.05.2010, p. 990-997.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Negative capsule endoscopy without subsequent enteroscopy does not predict lower long-term rebleeding rates in patients with obscure GI bleeding

AU - Park, Jae Jun

AU - Cheon, Jae Hee

AU - Kim, Hee Man

AU - Park, Hyeun Sung

AU - Moon, Chang Mo

AU - Lee, Jin Ha

AU - Hong, Sung Pil

AU - Kim, Tae Il

AU - Kim, Won Ho

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Background: Capsule endoscopy (CE) is now widely accepted as a first-line diagnostic modality for obscure GI bleeding (OGIB). However, the clinical implications of negative results of CE studies remain unclear. Objective: To investigate long-term (>1 year) outcomes for patients undergoing CE for OGIB and to identify risk factors associated with rebleeding. Design and Setting: Retrospective study in a tertiary care hospital. Methods: A total of 57 consecutive patients who had undergone CE for OGIB were enrolled and their pre- and post-CE clinical data were collected. Specific treatments were defined as treatments directly aimed at presumed bleeding causes including hemostasis and disease-specific medical therapy, whereas nonspecific treatments were defined as symptomatic treatments for anemia. Results: Of the 57 patients, the indication for CE was obscure-overt bleeding in 46 patients and obscure-occult bleeding in 11 patients. Among 51 patients for whom long-term data were available, significant (P2) lesions were found in 23 (45.1%) patients. The overall rebleeding rate was 35.3% during a median follow-up duration of 31.7 months (range 12.8-58.0 months). There was no statistically significant difference in the cumulative rebleeding rate between patients with positive and negative CE results (34.8% vs 35.7%, respectively; P = .989). However, specific treatments after CE (hazard ratio, 0.111; 95% CI, 0.013-0.980; P = .043) significantly decreased rebleeding. Limitations: Small number of patients, retrospective study design. Conclusions: The rebleeding rate for patients with OGIB and negative CE results was substantial, indicating that these patients should be closely observed. However, specific treatment after CE significantly reduced the incidence of recurrent bleeding.

AB - Background: Capsule endoscopy (CE) is now widely accepted as a first-line diagnostic modality for obscure GI bleeding (OGIB). However, the clinical implications of negative results of CE studies remain unclear. Objective: To investigate long-term (>1 year) outcomes for patients undergoing CE for OGIB and to identify risk factors associated with rebleeding. Design and Setting: Retrospective study in a tertiary care hospital. Methods: A total of 57 consecutive patients who had undergone CE for OGIB were enrolled and their pre- and post-CE clinical data were collected. Specific treatments were defined as treatments directly aimed at presumed bleeding causes including hemostasis and disease-specific medical therapy, whereas nonspecific treatments were defined as symptomatic treatments for anemia. Results: Of the 57 patients, the indication for CE was obscure-overt bleeding in 46 patients and obscure-occult bleeding in 11 patients. Among 51 patients for whom long-term data were available, significant (P2) lesions were found in 23 (45.1%) patients. The overall rebleeding rate was 35.3% during a median follow-up duration of 31.7 months (range 12.8-58.0 months). There was no statistically significant difference in the cumulative rebleeding rate between patients with positive and negative CE results (34.8% vs 35.7%, respectively; P = .989). However, specific treatments after CE (hazard ratio, 0.111; 95% CI, 0.013-0.980; P = .043) significantly decreased rebleeding. Limitations: Small number of patients, retrospective study design. Conclusions: The rebleeding rate for patients with OGIB and negative CE results was substantial, indicating that these patients should be closely observed. However, specific treatment after CE significantly reduced the incidence of recurrent bleeding.

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