Krstić M N, Martinov J, Krstić S N, Saranović D J, Lausević Z, Milosavjević T, Jovanović I, Alempijević T, Marisavljević D, Pesko P
Institut za bolesti digestivnog sistema KCS, Beograd.
Acta Chir Iugosl. 2007;54(1):25-33. doi: 10.2298/aci0701025k.
Capsule endoscopy (CE) is a new diagnostic tool for the study of patients with suspected small bowel pathology. The aim of the study was to clarify the usefulness of CE in the group of patients with obscure (overt / occult) gastrointestinal (GI) bleeding.
Thirty patients (14 men, 16 women, mean age 50 years, range 9 -79 years) were enrolled in the study. All of them undergone non-diagnostic esophagogastroduodenoscopy, colonoscopy and barium follow-through of the small bowel. All patients underwent capsule endoscopy. Fourteen patients had overt and sixteen occult bleeding. The single senior endoscopist interpreted CE findings in an unblinded manner.
CE identified a source of bleeding in 14/30 patients (46.6%). Lesions identified were: tumors in five pts, vascular lesions, Crohnzs disease and Meckelzs diverticulum in two pts and fresh bleeding, segmental celiac disease and colonic diverticulosis in one patient each. CE identified a source of bleeding in 9/14 (64.3%) of patients with ongoing overt bleeding and in only 5/16 (31.3%) of patients with occult bleeding. The positive suspicious findings were seen in 6/30 (20%) of patients (2/14 with overt bleeding and 4/16 with occult bleeding. In 3/14 (21.4%) with overt and 7/16 (43.7%) with occult bleeding findings on CE were negative. All patients with negative findings on follow-up remained asymptomatic for one year. Capsule retention because of unsuspected stenosis occurred in a single patient and required surgery, which resolved the problem.
CE is an effective diagnostic tool for patients with obscure GI bleeding. It is safe and painless technique which can diagnose the bleeding site beyond the reach of conventional endoscopy. The best candidates for the procedure are those with ongoing and overt bleeding.
胶囊内镜（CE）是用于研究疑似小肠病变患者的一种新型诊断工具。本研究的目的是阐明CE在不明原因（显性/隐性）胃肠道（GI）出血患者群体中的实用性。
30例患者（14例男性，16例女性，平均年龄50岁，范围9 - 79岁）纳入本研究。他们均接受了非诊断性食管胃十二指肠镜检查、结肠镜检查及小肠钡剂造影。所有患者均接受了胶囊内镜检查。14例为显性出血，16例为隐性出血。由一名资深内镜医师以非盲法解读CE检查结果。
CE在14/30例患者（46.6%）中发现了出血源。所发现的病变有：5例患者为肿瘤，2例患者为血管病变、克罗恩病和梅克尔憩室，另有1例患者分别为新鲜出血、节段性乳糜泻和结肠憩室病。CE在9/14例（64.3%）显性出血患者中发现了出血源，而在仅5/16例（31.3%）隐性出血患者中发现了出血源。6/30例（20%）患者有阳性可疑发现（2/14例显性出血患者和4/16例隐性出血患者）。CE检查结果在3/14例（21.4%）显性出血患者和7/16例（43.7%）隐性出血患者中为阴性。所有随访结果为阴性的患者在一年内均无症状。1例患者因未被怀疑的狭窄导致胶囊滞留，需手术治疗，问题得以解决。
CE是不明原因GI出血患者的一种有效诊断工具。它是一种安全、无痛的技术，可诊断常规内镜检查无法触及部位的出血部位。该检查的最佳适用人群是那些有持续性显性出血的患者。
