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Small-bowel capsule endoscopy (SBCE) plays a fundamental role in evaluating obscure gastrointestinal bleeding, principally for detecting lesions in the small intestine.
Small-bowel capsule endoscopy (SBCE) plays a fundamental role in evaluating obscure gastrointestinal bleeding, principally for detecting lesions in the small intestine. While the timing of SBCE is believed to influence its diagnostic effectiveness, the most suitable time frame for its usage remains uncertain. This retrospective study sought to evaluate SBCE's timing and its influence on the detection rate of bleeding sources.
Data from 131 patients who underwent SBCE for overt gastrointestinal bleeding were reviewed. Volunteers were grouped based on the time interval between their most recent bleeding episode and the SBCE procedure: 1–7 days, 8–14 days, 15–28 days, and ≥ 29 days.
Across all timing groups, the diagnostic yield remained around 50%, with no prominent variation between intervals. Vascular lesions were predominantly identified within the first 14 days, while inflammatory lesions, neoplasms, and diverticula were found throughout all time periods. Importantly, 25% of patients with initially negative SBCE results were subsequently diagnosed with bleeding sources outside the small bowel, underscoring the importance of additional endoscopic follow-up.
SBCE maintained diagnostic value regardless of when it was carried out after a bleeding event. These findings challenged earlier guidelines that favored early intervention. Clinicians are encouraged to consider SBCE whenever practical to boost diagnostic accuracy in cases of gastrointestinal bleeding, regardless of the delay since the last bleeding episode.
BMC Gastroenterology
A study on the timing of small-bowel capsule endoscopy and its impact on the detection rate of bleeding sources
Daisuke Kametaka et al.
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