Diagnostic yield of small-bowel capsule endoscopy in patients with iron deficiency anemia: Does it affect management?

9Citations
Citations of this article
6Readers
Mendeley users who have this article in their library.

Abstract

We read with interest the systematic review by Koulaouzidis et al, 1 who alluded that the validity of small-bowel capsule endoscopy in patients with iron defi-ciency anemia (IDA) alone remains limited. They found that studies focusing solely on IDA had a diagnostic yield of 66%, and significant findings included vascular (31%), in-flammatory (17.8%), and mass and/or tumor (7.95%) le-sions. We would like to share our findings. From a cohort of 1324 patients with obscure GI bleeding who underwent small-bowel capsule endoscopy, we identified 971 patients (73%) with IDA. The diagnostic yield was 35% (n Z 342) in the IDA group in which vascular lesions made up 23% (n Z 225), the combination of erosions and ulcers another 25% (n Z 245), and small-bowel tumors 2% (n Z 16) of lesions. Other findings included 42 patients with fresh blood without a definite source, 11 with small-bowel stric-tures, and 63 with miscellaneous lesions. In 135 patients (14%), lesions were identified outside the small bowel. Yield and management change between sexes revealed no statistical difference (P Z .67, P Z .37), whereas logistic regression revealed that age (P Z .001), transfusion depen-dence (P Z .037), and respiratory disease (P Z .047) were factors associated with a positive yield. In 61% (n Z 207) of cases with a diagnostic yield, subsequent management was altered. This was more likely in the patients who were transfusion dependent (P Z .004) and in patients with comorbidity (P Z .004). Small-bowel enteroscopy (either push or double-balloon enteroscopy) was performed in 19% (n Z 39) to treat vascular lesions (56%) or biopsy of abnormalities seen (44%). Patients who underwent entero-scopy also were more likely to have cardiovascular (P Z .004) or chronic liver disease (P Z .048) and transfusion dependence (P Z .04). This study supports the validity of capsule endoscopy in patients with IDA. We highlight clinical factors associated with a higher diagnostic yield, Figure 1. This figure accompanies the letter response by Chen and Hsieh, p. 799.

Cite

CITATION STYLE

APA

Sidhu, P. S., McAlindon, M. E., Drew, K., & Sidhu, R. (2013, November). Diagnostic yield of small-bowel capsule endoscopy in patients with iron deficiency anemia: Does it affect management? Gastrointestinal Endoscopy. https://doi.org/10.1016/j.gie.2013.06.022

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free