Capsule endoscopy in small bowel bleeding management
Journal Title: Хірургія України - Year 2018, Vol 0, Issue 1
Abstract
The aim — to study the role of capsule endoscopy in determination of small bowel bleeding management. Materials and methods. The study was based on 167 patients’ treatment results for intestinal bleeding at surgical and proctological departments. Patients were divided into two groups: the main one — 98 (62 (65.2 %) men and 36 (34.8 %) women, the average age 45.3 ± 1.3 years) patients treated since May 2013 to December 2015, whom were diagnosed and treated according to our new medical diagnostic algorithm, and the comparison group included 69 (34 (49.2 %) men and 35 (50.8 %) women, mean age (46.7 ± 1.3) years) patients treated during the period from April 2000 to December 2013, whom were diagnosed and treated according to the traditional scheme (esophagogastroduodenoscopy, videocolonoscopy, contrast X-ray of the small intestine, haemostatic and infusion therapy). Depending on the clinical signs, each group was divided into three subgroups. In the main group, 22 (22.45 %) patients with clinical signs of persistent bleeding (melena, bloody vomiting) entered the I subgroup, 29 (29.59 %) with stopped bleeding in the II subgroup, 47 (47.96 %) with recurrent bleeding and chronic anaemia of unknown origin (according to previous examinations), respectively in the comparison group 34 (49.28 %), 19 (27.54 %) and 16 (23.19 %) patients. Results and discussion. In the main group, with a capsule endoscopy, a source of bleeding was detected in 91 (89.4 %) patients. In the comparison group — the source of bleeding with the help of a traditional algorithm at the preoperative stage was detected in only 10 (14.5 %) patients. 14 (14.3 %) surgical interventions were performed in the main group, 9 (9.18 %) were planned and 5 (5.1 %) — in urgent order, in the comparison group — 53 (76.8 %), among them 13 (24.53) were planned and 40 (75.47 %) — in urgent order. Conclusions. Videocapsule endoscopy detected a source of bleeding in all patients with ongoing bleeding signs, in 93.1 % of patients without bleeding signs, and 89.4 % in patients with recurrent bleeding and chronic anaemia of unknown ethology. The use of capsular endoscopy made it possible to reduce the level of surgical interventions by 62.69, 45.92 and 25.0 %, and urgent surgical interventions by 70.37, 59.89 and 51.9 %, respectively.
Authors and Affiliations
Ya. P. Feleshtinskiy, U. I. Grechana
Keywords
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