The Application Of Capsule Endoscopy And CT Virtual Endoscopy In Obscure Gastrointestinal Bleeding

Obscure gastrointestinal bleeding (OGIB) is defined as bleeding of unknown reason that can’t bedetected by initial endoscopic evaluation, the lesions often located in the small intestine, incidence of adisease is3%-5%. OGIB is classified as either overt OGIB, which manifests as recurrent melena orhematochezia, or occult OGIB, which manifests by recurrent or persistent iron deficiency anemia despiteiron replacement therapy. Common pathogenesis is vascular malformation.Small intestine is the longest organ of human body, the overall length of5to7m, mesenteric boundcan easily form multiple compound intestinal loop, which is difficult to check, the traditional smallintestine barium meal examination technology, has been called the "dark zone" because of extremelylow positive detection rate; But as to the capsule endoscopy (capsule endoscopy, CE) and enteroscopyand other new technology application, diagnosis rate of OGIB is improving.CE is the small intestine inspection method. It has higher positive rate, because of its non-invasive,and ablity to well-observe the small intestine mucosal directly can be observed small intestine mucosaldirectly，which make it gradually become the main inspection means, especially in patients with OGIB。But the limitation of capsule endoscopy is obvious too, including its inability to observe the relationshipbetween the small intestine and surrounding tissues, or to understand infiltration depth of lesions, etc.The multidetector-row CT as technology which development rapidly at present, its application arehighly valued in the small intestinal disease. Although the application of new technology,is going toimprove the diagnosis rate of OGIB, but the bleeding reason of some people is still unclear, and eachinspection technology have different advantages and disadvantages, all can’t fully understand the lesionspanorama.Objective: to study the application value of the capsule endoscopy and64row CT virtual endoscopyin the OGIB。Methods:83cases were collected who suffering from OGIB and have been diagnosed and receivedtreatment in our hospital from March2010to July2012.Have been divided into three groups, theyunderwent CE、64row CT virtual endoscopy、64row CT virtual endoscopy combine with CE. Contrast positive rate between three groups have been collected，the aim is to investigate the application value of64row CT virtual endoscope in OGIB.Results:(1)30cases underwent CE, in which23cases found lesions,the positive rate is76.7%, amongwhich the primary cause is vascular malformations；(2)27cases underwent64row CT virtual endoscopy, in which15cases found lesion, the positiverate is55.6%, the primary cause is Intestinal lesions;(3)26cases who underwent CE combine with64row CT virtual endoscopy, all patients underwentCE firstly, then underwent64row CT virtual endoscopy, in which22cases were dound lesions, thepositive rate is84.6%, the primary cause is small intestine disease occupied;(4) According to statistical analysis, which has statistical significance between three data, but thereis no statistical significance between CE group、64row CT virtual endoscopy、and CE combine with64row CT virtual endoscopy, it has statistical analysis between64row CT virtual endoscopy and CEcombine with64row CT virtual endoscopyConclusion:CE combine with64row CT virtual endoscopy cannot improve the positive rate of diagnosis ofgastrointestinal bleeding, but can provides guidance for The next step treatment，and help to makeoperation scheme for surgery patients.