Improved diagnostic yield with severity bleeding


The Journal of Digestive Diseases has published a report by Dr DA Parikh et al which looks that the benefits of using Video Capsule Endoscopy (VCE) to guide further interventions to support the treatment of severely bleeding patients.

Read the full report here.

A summary of the report, as provided by the Journal of Digestive Diseases, is provided below:

OBJECTIVE:  Video capsule endoscopy (VCE) is an important tool for non-invasive imaging of the small bowel (SB). Whether there is a dose-related effect of anaemia severity on the diagnostic yield of VCE is unknown. The aim of this study is to determine the influence of anaemia severity on VCE outcome measures.

METHODS:  VCE studies from the Sacramento Veterans Affairs (VA) Medical Centre for 300 consecutive patients were retrospectively screened. Those with anaemia were selected. Patients were grouped as mildly, moderately, or severely bleeding. Outcomes data including completion of study, diagnostic yield and further intervention were compared.

RESULTS:  Of the 300 patients, 210 (70%) were found to have anaemia. Thirty-two (15.2%) patients were mildly, 145 (69.0%) were moderately and 33 (15.7%) were severely bleeding. The diagnostic yield was significantly higher in severely bleeding (72.7%) relative to moderately bleeding (32.4%) and mildly bleeding (12.5%) patients, P = 0.0001. Significantly more angioectasias were detected in severely bleeding patients (42.4%) relative to moderately (14.5%) and mildly (0%) bleeding patients, P = 0.0001. The ability of VCE to guide further intervention was significantly higher in severely bleeding patients (69.7%, P = 0.006).

CONCLUSIONS:  Our data showed a significant increase in diagnostic yield with increasing degree of anaemia. Relative difference in haemoglobin rather than absolute values may be a better predictor. The ability of VCE to guide further intervention reached significance in severely bleeding patients. The hypothesis that use of VCE prior to EGD or colonoscopy in the severely bleeding group deserves to be evaluated.