In:
Digestion, S. Karger AG, Vol. 103, No. 5 ( 2022), p. 367-377
Abstract:
〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Although most patients with presumptive colonic diverticular bleeding (CDB) do not undergo a small bowel investigation in clinical practice, no prospective study supports this management. We evaluated the utility of early small bowel capsule endoscopy (CE) after negative colonoscopy results. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This prospective study evaluated the diagnostic yield of early small bowel CE (≤3 days from visit) for consecutive patients with acute-onset hematochezia, when colonoscopy found colonic diverticulosis but did not identify the definite bleeding source ( 〈 i 〉 n 〈 /i 〉 = 51; presumptive CDB). As a matched control for comparing clinical outcomes, presumptive CDB patients without CE ( 〈 i 〉 n 〈 /i 〉 = 51) were retrospectively extracted. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 On CE for the prospective cohort, the rates of total positive findings, P2 findings (high bleeding potential according to the P classification), and blood pooling in the colon were 57%, 12% (ulceration, 8%; angioectasia, 4%), and 24%, respectively. The rates of rebleeding within 30 and 365 days were 16% and 29% in the prospective cohort with CE, respectively, and were not significantly different from those in the retrospective cohort without CE (10% and 25%, respectively). In addition, thromboembolism and mortality within 30 and 365 days were not significantly different between those with and without CE. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Early CE detected a suspected small bowel bleeding source in 12% of acute-onset presumptive CDB patients but did not significantly improve major clinical outcomes. Therefore, routine CE is unnecessary for presumptive CDB patients after colonoscopy (UMIN000026676).
Type of Medium:
Online Resource
ISSN:
0012-2823
,
1421-9867
Language:
English
Publisher:
S. Karger AG
Publication Date:
2022
detail.hit.zdb_id:
1482218-0
