The Diagnostic Value Of Capsule Endoscopy In Patients With Obscure Gastrointestinal Bleeding

Objective To analyze the diagnostic value of capsule endoscopy in patients with obscure gastrointestinal bleeding.Methods This study retrospectively analyzed 312 patients who underwent capsule endoscopy for obscure gastrointestinal bleeding in Wuhan Union Hospital from January 2012 to October 2016,analyzed the results of the capsule endoscopy. The diagnostic yield is defined as the percentage that examination results which can clearly explain bleeding reason accounts for the total results, and the detection rate is defined as the percentage that examination results which can clearly or can not fully explain bleeding reason accounts for the total results. We calculated the diagnostic yield and detection rate.Results 1.The diagnostic yield of the 312 patients was 59.29% and the detection rate was 73.40%. 2. There were no significant differences in the diagnostic yield and the detection rate between the Miro Cam capsule endoscopy and SB2 Pill Cam capsule endoscopy(P=0.695, P=0.352). 3. Both of the diagnostic yield and the detection rate of the female patients were significantly higher than that of the male patients(72.13%vs51.05%, P=0.000217)(79.51%vs69.47%, P = 0.05).It may be associated with the fact that the morbidity rate of vascular malformation in female patients was significant higher than that in male patients(36.07 %vs 17.89%,P = 0.000298).4. The diagnostic yield of the patients who was 60 or older than 60 was significantly higher than that of the patients who was younger than 60(67.57%vs54.73%,P=0.027). It may be associated with the fact that the morbidity rate of vascular malformation in patients who was 60 or older than 60 was significant higher than that in patients who was younger than 60(38.74% vs 17.41%,P = 0.000031). 5. The detection rate of the overt obscure gastrointestinal bleeding patients was significantly higher than that of the occult obscure gastrointestinal bleeding patients(75.47%vs59.38%, P=0.051), but there were no differences between their detected diseases. 6. On logistic regression analysis,gender was associated with the diagnostic yield of capsule endoscopy(P=0.001),and clinical manifestation was associated with the detection rate of capsule endoscopy(P=0.032).7.Capsule retention occurred in 3 patients of the total 312 patients.The capsule retention rate was 0.96%.All of the 3 patients underwent surgical treatment. The postoperative pathological results were Crohn’s disease.Conclusion The diagnostic yield and detection rate of capsule endoscopy in patients with obscure gastrointestinal bleeding are high,and the capsule retention rate is low. The diagnostic yield and detection rate in female patients are high,the diagnostic yield in old patients is high.It may be associated with the fact that the morbidity rate of vascular malformation in female patients and old patients are high. The detection rate of the overt obscure gastrointestinal bleeding patients are high.The diagnostic yield and detection rate of the two different capsule endoscopy are alike. Patients with Crohn’s disease should be carefully considered for capsule endoscopy.