Iwamoto Junichi, Mizokami Yuji, Shimokobe Koichi, Yara Shoichiro, Murakami Masashi, Kido Kozue, Ito Masanori, Hirayama Takeshi, Saito Yoshifumi, Honda Akira, Ikegami Tadashi, Ohara Tadashi, Matsuzaki Yasushi
Department of Gastroenterology, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan.
Hepatogastroenterology. 2011 Mar-Apr;58(106):301-5.
BACKGROUND/AIMS: Capsule endoscopy (CE) represents a significant advance in the investigation of small bowel diseases. Little is known about the clinical outcome of patients with obscure gastrointestinal bleeding (OGIB).
Seventy-eight patients underwent CE for OGIB and were followed up for at least 6 months after CE. The diagnostic yield of CE and the rate of re-bleeding during the follow-up period were established.
Out of our 78 OGIB patients, 35 (44.9%) had significant lesions. There was a significant difference in the rate of identification of significant lesions between the on-going overt bleeding cases and previous overt bleeding cases (68.8% vs. 37.8%, respectively, p=0.043). Of the 46 patients with significant or insignificant lesions, 12 (26.1%) had one or more re-bleeding episodes during the follow-up period. On the other hand, only one (4%) of the 26 patients with negative findings had a re-bleeding episode (p=0.025).
In conclusion, our study confirmed the role of CE in the diagnosis of OGIB, especially in the on-going overt bleeding cases. The OGIB patients with negative CE findings showed a low re-bleeding rate in the follow-up period. Further long-term follow-up studies are needed in future to examine the negative CE cases.
背景/目的:胶囊内镜检查(CE)是小肠疾病诊断的一项重大进展。关于不明原因消化道出血(OGIB)患者的临床结局知之甚少。
78例OGIB患者接受了CE检查,并在CE检查后至少随访6个月。确定了CE的诊断率和随访期间的再出血率。
在我们的78例OGIB患者中,35例(44.9%)有明显病变。正在发生显性出血的病例和既往显性出血的病例之间,明显病变的识别率有显著差异(分别为68.8%和37.8%,p = 0.043)。在46例有明显或不明显病变的患者中,12例(26.1%)在随访期间有一次或多次再出血事件。另一方面,26例检查结果为阴性的患者中只有1例(4%)有再出血事件(p = 0.025)。
总之,我们的研究证实了CE在OGIB诊断中的作用,尤其是在正在发生显性出血的病例中。CE检查结果为阴性的OGIB患者在随访期间再出血率较低。未来需要进一步进行长期随访研究以检查CE检查结果为阴性的病例。