Lee Beom Jae, Chun Hoon Jai, Koo Ja Soul, Keum Bora, Park Sang Hoon, Kim Du Rang, Kwon Yong Dae, Kim Yong Sik, Jean Yoon Tae, Lee Hong Sik, Um Soon Ho, Lee Sang Woo, Choi Jai Hyun, Kim Chang Duck, Ryu Ho Sang
Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2007 Feb;49(2):79-84.
BACKGROUND/AIMS: Capsule endoscopy (CE) has become a valuable modality for the detection of small bowel lesions. The usefulness of CE for obscure gastrointestinal (GI) bleeding has been established with an overall diagnostic yield of 60%. It is unknown whether CE is of equal value in all the patients or of greater benefit in selected groups in Korea. We evaluated the factors that affect the diagnostic yields of CE in patients with obscure GI bleeding.
CE was performed in 126 consecutive patients [74 men and 52 women mean age 52.5 years (25-75 yrs), 23 with active bleeding] with obscure GI bleeding between September 2002 and July 2004. Patients were divided into two groups: those with documented bleeding lesions and those with non specific CE findings. We analyzed the clinical characteristics and other parameters that influenced the diagnostic yields of CE.
A definite or probable cause for obscure GI bleeding was found in 69% (80/116) of the patients. NSAID induced ulcer (16.4%) and angiodysplasia (12.1%) were the most common diagnoses. In patients with active bleeding, the diagnostic yield was significantly greater than that of the patients with occult bleeding (80% vs. 68.3%, p<0.05). However, there was no significant difference in parameters between patients with abnormal CE and those with normal CE in respect to gender, age, previous bleeding history, need for transfusion, cecum imaging, and bowel preparation.
The diagnostic yield of CE in patients with obscure GI bleeding is 69%. It is significantly higher in patients with active bleeding.
背景/目的：胶囊内镜（CE）已成为检测小肠病变的一种有价值的方法。CE对不明原因胃肠道（GI）出血的有效性已得到证实，总体诊断率为60%。在韩国，CE在所有患者中是否具有同等价值或在特定人群中是否更有益尚不清楚。我们评估了影响不明原因GI出血患者CE诊断率的因素。
2002年9月至2004年7月，对126例连续的不明原因GI出血患者[74例男性和52例女性，平均年龄52.5岁（25 - 75岁），23例有活动性出血]进行了CE检查。患者分为两组：有记录的出血性病变患者和CE检查结果无特异性的患者。我们分析了影响CE诊断率的临床特征和其他参数。
69%（80/116）的患者发现了不明原因GI出血的确切或可能原因。非甾体抗炎药引起的溃疡（16.4%）和血管发育异常（12.1%）是最常见的诊断。在有活动性出血的患者中，诊断率显著高于隐匿性出血患者（80%对68.3%，p<0.05）。然而，在性别、年龄、既往出血史、输血需求、盲肠成像和肠道准备方面，CE异常患者和CE正常患者之间的参数没有显著差异。
不明原因GI出血患者的CE诊断率为69%。在有活动性出血的患者中显著更高。
