Background and study aims: Many lesions found during push enteroscopy to evaluate obscure gastrointestinal bleeding are within the reach of standard endoscopes. The aim of this study was to determine whether the rate ...Background and study aims: Many lesions found during push enteroscopy to evaluate obscure gastrointestinal bleeding are within the reach of standard endoscopes. The aim of this study was to determine whether the rate of proximal lesions varies in relation to the type of obscure bleeding that is present. Patients and methods: A retrospective review of consecutive push enteroscopies carried out for obscure gastrointestinal bleeding between July 1996 and July 2000 was conducted. The patients were categorized into three groups: those with recurrent obscure/overt gastrointestinal bleeding; those with persistent obscure/overt gastrointestinal bleeding; and those with obscure/ occult gastrointestinal bleeding. Results: A total of 63 patients (24 men, 39 women; mean age 69.8) were included. Push enteroscopy examinations were conducted for recurrent obscure/overt bleeding in 32 patients; for persistent obscure/overt bleeding in 12 patients; and for obscure/occult bleeding in 19 patients. The overall diagnostic yield of push enteroscopy was 47% (15 of 32) in the group with recurrent obscure/overt bleeding; 66% (eight of 12) in the group with persistent obscure/overt bleeding; and 63% (12 of 19) in the group with obscure/occult bleeding. However, when lesions within the reach of standard esophagogastroduodenoscopy (EGD)were excluded, the yield of push enteroscopy was slightly higher in the group with recurrent obscure/overt bleeding (41% ) than in the groups with persistent obscure/overt bleeding (33% ) and obscure/ occult bleeding (26% ). There were fewer lesions within the reach of EGD in the group with recurrent obscure/overt bleeding than in the groups with persistent obscure/overt bleeding (6% vs. 33% ; P < 0.05) or obscure/occult bleeding (6% vs. 37% ; P < 0.05). Conclusions: Patients undergoing push enteroscopy for recurrent obscure/overt bleeding were significantly less likely to have lesions within the reach of EGD than patients with persistent obscure/overt bleeding or obscure/occult bleed-ing. Patients in the latter two groups would be able to undergo a repeat EGD examination before more intense evaluation with push enteroscopy or capsule endoscopy.展开更多
Background: The “Suspected Blood Indicator”(SBI), a feature included in the software for interpretation of capsule endoscopy(CE), is designed to facilitate detection of bleeding lesions in the small bowel. This stud...Background: The “Suspected Blood Indicator”(SBI), a feature included in the software for interpretation of capsule endoscopy(CE), is designed to facilitate detection of bleeding lesions in the small bowel. This study evaluated the sensi tivity and the specificity of the SBI in patients who underwent CE for obscure G I bleeding (OGIB). Methods: CE recordings from patients with OGIB recruited in 7 centers were read by experts blinded to the red SBI tags. They classified lesio ns of interest as bleeding or as having a potential for bleeding that was high ( P2), low (P1), or absent (P0). The SBI tags then were marked by a another invest igator.Concordance was acknowledged when frames selected by the expert reader, a nd those tagged by the SBI had the same time code. Results: A total of 156 recor dings were evaluated.In 83, there was either. no lesion (n = 71) or a P0 lesion (n= 12); these CE recordings were regarded as normal. Among the 73 abnormal reco rdings, 114 P2 and 92 P1 lesions were identified. A total of 154 red tags were a nalyzed. Sensitivity,specificity, and positive and negative predictive values of SBI were 37%, 59%, 50%, and 46%, respectively, for detection of the presenc e of a P2 or P1 lesion in front of a red tag.Conclu- sions: SBI-based detection of intestinal lesions with the potential for bleed ing is of limited clinical value in practice and does not reduce the time requir ed for interpretation of CE.展开更多
文摘Background and study aims: Many lesions found during push enteroscopy to evaluate obscure gastrointestinal bleeding are within the reach of standard endoscopes. The aim of this study was to determine whether the rate of proximal lesions varies in relation to the type of obscure bleeding that is present. Patients and methods: A retrospective review of consecutive push enteroscopies carried out for obscure gastrointestinal bleeding between July 1996 and July 2000 was conducted. The patients were categorized into three groups: those with recurrent obscure/overt gastrointestinal bleeding; those with persistent obscure/overt gastrointestinal bleeding; and those with obscure/ occult gastrointestinal bleeding. Results: A total of 63 patients (24 men, 39 women; mean age 69.8) were included. Push enteroscopy examinations were conducted for recurrent obscure/overt bleeding in 32 patients; for persistent obscure/overt bleeding in 12 patients; and for obscure/occult bleeding in 19 patients. The overall diagnostic yield of push enteroscopy was 47% (15 of 32) in the group with recurrent obscure/overt bleeding; 66% (eight of 12) in the group with persistent obscure/overt bleeding; and 63% (12 of 19) in the group with obscure/occult bleeding. However, when lesions within the reach of standard esophagogastroduodenoscopy (EGD)were excluded, the yield of push enteroscopy was slightly higher in the group with recurrent obscure/overt bleeding (41% ) than in the groups with persistent obscure/overt bleeding (33% ) and obscure/ occult bleeding (26% ). There were fewer lesions within the reach of EGD in the group with recurrent obscure/overt bleeding than in the groups with persistent obscure/overt bleeding (6% vs. 33% ; P < 0.05) or obscure/occult bleeding (6% vs. 37% ; P < 0.05). Conclusions: Patients undergoing push enteroscopy for recurrent obscure/overt bleeding were significantly less likely to have lesions within the reach of EGD than patients with persistent obscure/overt bleeding or obscure/occult bleed-ing. Patients in the latter two groups would be able to undergo a repeat EGD examination before more intense evaluation with push enteroscopy or capsule endoscopy.
文摘Background: The “Suspected Blood Indicator”(SBI), a feature included in the software for interpretation of capsule endoscopy(CE), is designed to facilitate detection of bleeding lesions in the small bowel. This study evaluated the sensi tivity and the specificity of the SBI in patients who underwent CE for obscure G I bleeding (OGIB). Methods: CE recordings from patients with OGIB recruited in 7 centers were read by experts blinded to the red SBI tags. They classified lesio ns of interest as bleeding or as having a potential for bleeding that was high ( P2), low (P1), or absent (P0). The SBI tags then were marked by a another invest igator.Concordance was acknowledged when frames selected by the expert reader, a nd those tagged by the SBI had the same time code. Results: A total of 156 recor dings were evaluated.In 83, there was either. no lesion (n = 71) or a P0 lesion (n= 12); these CE recordings were regarded as normal. Among the 73 abnormal reco rdings, 114 P2 and 92 P1 lesions were identified. A total of 154 red tags were a nalyzed. Sensitivity,specificity, and positive and negative predictive values of SBI were 37%, 59%, 50%, and 46%, respectively, for detection of the presenc e of a P2 or P1 lesion in front of a red tag.Conclu- sions: SBI-based detection of intestinal lesions with the potential for bleed ing is of limited clinical value in practice and does not reduce the time requir ed for interpretation of CE.
