Estévez Emilio, González-Conde Benito, Vázquez-Iglesias José Luis, de Los Angeles Vázquez-Millán Maria, Pértega Sonia, Alonso Pedro A, Clofent Joan, Santos Eva, Ulla José Luis, Sánchez Eloy
Department of Gastroenterology, Complexo Hospitalario Juan Canalejo, A Coruña, Spain. estevez@canalejo
Eur J Gastroenterol Hepatol. 2006 Aug;18(8):881-8. doi: 10.1097/00042737-200608000-00014.
The endoscopic capsule is a useful tool for visualizing the small bowel in patients with obscure gastrointestinal bleeding. In this study the authors evaluated the diagnostic aid provided by the endoscopic capsule, the factors predicting a significant finding and their impact on the patients' clinical evolution.
A total of 100 patients (52 men and 48 women, average age 64.4 years) underwent capsule endoscopy. Of this group, 52 patients presented with obscure-overt bleeding and 48 with obscure-occult bleeding. After an average follow-up time of 11.4 months, the clinical outcome was evaluated in 95 patients.
The endoscopic capsule identified significant findings in 68% of patients. The most common diagnosis (33.8%) was angiodysplasias. The most important factor predicting significant findings was the previous need for transfusion in the overt bleeding group. As the result of the findings, a specific intervention was made in 75.8% of patients. At the end of follow-up, the clinical outcome was considered positive in 71.6% of patients. Capsule retention occurred in one patient, who required surgery.
In patients with obscure gastrointestinal bleeding, capsule endoscopy provides a high degree of diagnostic aid. The best candidates for this procedure are patients with obscure-overt bleeding who have required blood transfusions. Capsule endoscopy has a positive influence on an important proportion of patients, whether oriented towards new diagnostic techniques or towards a definitive treatment.
内镜胶囊是一种用于观察不明原因胃肠道出血患者小肠的有用工具。在本研究中，作者评估了内镜胶囊提供的诊断辅助、预测重要发现的因素及其对患者临床进展的影响。
共有100例患者（52例男性和48例女性，平均年龄64.4岁）接受了胶囊内镜检查。其中，52例患者表现为不明原因显性出血，48例患者表现为不明原因隐性出血。平均随访11.4个月后，对95例患者的临床结果进行了评估。
内镜胶囊在68%的患者中发现了重要发现。最常见的诊断（33.8%）是血管发育异常。预测重要发现的最重要因素是显性出血组先前需要输血。由于这些发现，75.8%的患者进行了特定干预。随访结束时，71.6%的患者临床结果被认为是阳性的。1例患者发生胶囊滞留，需要手术治疗。
对于不明原因胃肠道出血患者，胶囊内镜提供了高度的诊断辅助。该检查的最佳候选者是需要输血的不明原因显性出血患者。胶囊内镜对很大一部分患者有积极影响，无论是针对新的诊断技术还是确定性治疗。
