Capsule endoscopy – accurate diagnosis method for detection of obscure digestive bleedings and secondary chronic anemia

Abstract

Background. Capsule endoscopy is a revolutionary new diagnostic method for the detection of digestive diseases, especially localized at the level of small bowel and colorectal tract. This method is the only technique that allows endoscopic examination of the digestive tract without sedation. Obscure gastrointestinal bleeding is the most common indication for capsule endoscopy, which commonly diagnoses arteriovenous malformations, small bowel tumors, ulcers or tumors missed at standard endoscopy or other imaging examinations [1]. Aim. Our study aimed to detect the accuracy of endoscopic videocapsule in detecting the cause of microscopic anemia in patients with supposed digestive pathologies. Material and method. We used PillCam 2 Platform provided by Given Imaging, a system consisting of PillCam 2 videocapsules, a data recorder, a set of sensors and the Rapid 7 Access computer soft capable to receive and transform pictures into films, in order to visualize the entire digestive gastrointestinal tract. We examined 25 patients with chronic anemia, all of them without any known hematologic, renal or digestive disease, investigated by standard imagistic and lab techniques. Results. From the total of 25 investigated patients, 18 (72%) of them presented sources of bleeding discovered with videocapsule endoscopy. The source of bleeding was the small bowel in 10 cases (55%) and the colorectal tract in 8 cases (45%). The accuracy of videocapsule was very good for detecting the digestive tract obscure sources of bleeding (Sn=74%, Sp=87%). Conclusions. The videocapsule endoscopy is an accurate imagistic option to detect digestive sources of bleeding and to identify the cause of many chronic anemia