Capsule Endoscopy for the Diagnosis of Suspected Small Bowel Bleeding
https://doi.org/10.35401/2541-9897-2023-26-3-121-128
Abstract
This review discusses the role of capsule endoscopy in diagnosing suspected small bowel bleeding and compares guidelines of the European Society of Gastrointestinal Endoscopy (ESGE), the American College of Gastroenterology (ACG), the American Society for Gastrointestinal Endoscopy (ASGE), the Canadian Association of Gastroenterology (CAG), and the consensus document of 4 Japanese medical societies. European and North American experts recommend capsule endoscopy as a first-line diagnostic modality for suspected small bowel bleeding without life-threatening signs in adult patients when ileocolonoscopy and esophagogastroduodenoscopy failed to be informative. Japanese experts, on the contrary, prefer cross-sectional imaging “from the chest to the pelvis” and consider capsule endoscopy as an alternative.
About the Authors
P. P. PolyakovRussian Federation
Pavel P. Polyakov, Cand. Sci. (Med.), Assistant Professor
Department of General and Clinical Pathophysiology
350063
ulitsa M. Sedina 4
Krasnodar
A. Ya. Alimetov
Russian Federation
Anar Ya. Alimetov, Surgeon
Krasnodar
A. V. Onopriev
Russian Federation
Alexandr V. Onopriev, Professor
Surgery Department No. 1, Faculty of Continuing Professional Development and Retraining
Krasnodar
A. V. Avakimyan
Russian Federation
Andrey V. Avakimyan, Cand. Sci. (Med.), Chief Physician
Krasnodar
A. Kh. Kade
Russian Federation
Azamat Kh. Kade, Dr. Sci. (Med.), Professor, Head of the Department
Department of General and Clinical Pathophysiology
Krasnodar
S. A. Zanin
Russian Federation
Sergey A. Zanin, Cand. Sci. (Med.), Associate Professor
Department of General and Clinical Pathophysiology
Krasnodar
E. S. Zanina
Russian Federation
Ekaterina S. Zanina, 5th Year Student
Faculty of General Medicine
Krasnodar
Z. S. Popov
Russian Federation
Zakhar S. Popov, 6th Year Student
Faculty of General Medicine
Krasnodar
A. I. Trofimenko
Russian Federation
Artem I. Trofimenko, Cand. Sci. (Med.), Associate Professor
Department of General and Clinical Pathophysiology
Krasnodar
Z. T. Jndoyan
Armenia
Zinaida T. Jndoyan, Dr. Sci. (Med.), Professor, Head of the Department
Internal Disease Propedeutics Department
Yerevan
A. A. Avagimyan
Armenia
Ashot A. Avagimyan, Cand. Sci. (Med.), Assistant Professor
Department of Pathological Anatomy and Clinical Morphology
Yerevan
References
1. Pennazio M, Rondonotti E, Despott EJ, et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2022. Endoscopy. 2023;55(1):58–95. PMID: 36423618. doi: 10.1055/a-1973-3796
2. Gerson LB, Fidler JL, Cav DR, Leighton JA. ACG clinical guideline: diagnosis and management of small bowel bleeding. Am J Gastroenterol. 2015;110(9):1265–1288. PMID: 26303132. doi: 10.1038/ajg.2015.246
3. ASGE Standards of Practice Committee, Gurudu SR, Bruining DH, et al. The role of endoscopy in the management of suspected small-bowel bleeding. Gastrointest Endosc. 2017;85(1):22–31. PMID: 27374798. doi: 10.1016/j.gie.2016.06.013
4. Enns RA, Hookey L, Armstrong D, et al. Clinical practice guidelines for the use of video capsule endoscopy. Gastroenterology. 2017;152(3):497–514. PMID: 28063287. doi: 10.1053/j.gastro.2016.12.032
5. Yamamoto H, Ogata H, Matsumoto T, et al. Clinical practice guideline for enteroscopy. Dig Endosc. 2017;29(5):519–546. PMID: 28370422. doi: 10.1111/den.12883
6. Papaefthymiou A, Ramai D, Maida M, et al. Performance and safety of motorized spiral enteroscopy: a systematic review and meta-analysis. Gastrointest Endosc. 2023;97(5):849–858.e5. PMID: 36738795. doi: 10.1016/j.gie.2023.01.048
7. Alemanni LV, Fabbri S, Rondonotti E, Mussetto A. Recent developments in small bowel endoscopy: the “black box” is now open!. Clin Endosc. 2022;55(4):473–479. PMID: 35831981. PMCID: PMC9329645. doi: 10.5946/ce.2022.113
8. Schneider M, Höllerich J, Beyna T. Device-assisted enteroscopy: a review of available techniques and upcoming new technologies. World J Gastroenterol. 2019;25(27):3538–3545. PMID: 31367155. PMCID: PMC6658397. doi: 10.3748/wjg.v25.i27.3538
9. Belov DV, Garbuzenko DV, Lukin OP, Anufrieva SS. Heyde’s syndrome as a rare cause of gastrointestinal bleeding in aortic stenosis patients. Cardiovascular Therapy and Prevention. 2021;20(1):59–64. (In Russ.). doi: 10.15829/1728-8800-2021-2503
10. Popov AYu, Petrovsky AN, Zamsha DG, Lischenko AN, Grigorov SP, Baryshev AG. A rare complication of chronic pancreatitis. Annals of HPB Surgery. 2017;22(3):82–85. (In Russ.). doi: 10.16931/1995-5464.2017382-86
11. Keuchel M, Kurniawan N, Baltes P. Small bowel ulcers: when is it not inflammatory bowel disease ?. Curr Opin Gastroenterol. 2019;35(3):213–222. PMID: 30865040. doi: 10.1097/MOG.0000000000000522
12. Parfenov АI, Akopova АО, Shcherbakov PL, Мikcheeva ОМ. Role of video capsule endoscopy in the diagnostic algorithm of small bowel Crohn’s disease. Ter Arkh. 2019;91(4):37–42. (In Russ.). PMID: 31094474. doi: 10.26442/00403660.2019.04.000079
13. Akopova AO, Mikcheeva OM, Shcherbakov PL, Parfenov AI. Helminths detection with video capsule endoscopy. Ter Arkh. 2019;91(11):72–74. (In Russ.). PMID: 32598614. doi: 10.26442/00403660.2019.11.000420
14. Nambu R, Warner N, Mulder DJ, et al. A systematic review of monogenic inflammatory bowel disease. Clin Gastroenterol Hepatol. 2022;20(4):e653–e663. PMID: 33746097. PMCID: PMC8448782. doi: 10.1016/j.cgh.2021.03.021
15. Gaisinskaya P, Sugerik S, Gebara CM. Ascaris lumbricoides diagnosed during evaluation of iron deficiency anemia by capsule endoscopy. Cureus. 2022;14(5):e25208. PMID: 35747027. PMCID: PMC9213257. doi: 10.7759/cureus.25208
16. Abbruzzi F, Loconte I, Carparelli S, Ierardi E, Di Leo A, Principi M. Olmesartan associated enteropathy: usefulness of video capsule endoscopy in a case with doubtful upper endoscopic/histological picture. Curr Drug Saf. 2020;15(1):65–68. PMID: 31549594. doi: 10.2174/1574886314666190923161406
17. Yamaguchi S, Yanai S, Nakamura S, et al. Immunohistochemical differentiation between chronic enteropathy associated with SLCO2A1 gene and other inflammatory bowel diseases. Intest Res. 2018;16(3):393–399. PMID: 30090038. PMCID: PMC6077302. doi: 10.5217/ir.2018.16.3.393
18. Hartmann D, Schmidt H, Bolz G, et al. A prospective twocenter study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding. Gastrointest Endosc. 2005;61(7):826–832. PMID: 15933683. doi: 10.1016/s0016-5107(05)00372-x
19. Teshima CW, Kuipers EJ, van Zanten SV, Mensink PB. Double balloon enteroscopy and capsule endoscopy for obscure gastrointestinal bleeding: an updated meta-analysis. J Gastroenterol Hepatol. 2011;26(5):796–801. PMID: 21155884. doi: 10.1111/j.1440-1746.2010.06530.x
20. Brito HP, Ribeiro IB, de Moura DTH, et al. Video capsule endoscopy vs double-balloon enteroscopy in the diagnosis of small bowel bleeding: a systematic review and meta-analysis. World J Gastrointest Endosc. 2018;10(12):400–421. PMID: 30631404. PMCID: PMC6323498. doi: 10.4253/wjge.v10.i12.400
21. Kim ER. Roles of capsule endoscopy and device-assisted enteroscopy in the diagnosis and treatment of small-bowel tumors. Clin Endosc. 2020;53(4):410–416. PMID: 32746538. PMCID: PMC7403020. doi: 10.5946/ce.2020.161
22. Hanscom M, Stead C, Feldman H, Marya NB, Cave D. Video capsule endoscopy and device-assisted enteroscopy. Dig Dis Sci. 2022;67(5):1539–1552. PMID: 34383197. PMCID: PMC8358900. doi: 10.1007/s10620-021-07085-0
23. de Leusse A, Vahedi K, Edery J, et al. Capsule endoscopy or push enteroscopy for first-line exploration of obscure gastrointestinal bleeding?. Gastroenterology. 2007;132(3):855–862. PMID: 17324401. doi: 10.1053/j.gastro.2006.12.002
24. Segarajasingam DS, Hanley SC, Barkun AN, et al. Randomized controlled trial comparing outcomes of video capsule endoscopy with push enteroscopy in obscure gastrointestinal bleeding. Can J Gastroenterol Hepatol. 2015;29(2):85–90. PMID: 25803018. PMCID: PMC4373566. doi: 10.1155/2015/897567
25. Laine L, Sahota A, Shah A. Does capsule endoscopy improve outcomes in obscure gastrointestinal bleeding? Randomized trial versus dedicated small bowel radiography. Gastroenterology. 2010;138(5):1673–e12. PMID: 20138043. doi: 10.1053/j.gastro.2010.01.047
26. Leung WK, Ho SS, Suen BY, et al. Capsule endoscopy or angiography in patients with acute overt obscure gastrointestinal bleeding: a prospective randomized study with long-term follow-up. Am J Gastroenterol. 2012;107(9):1370–1376. PMID: 22825363. doi: 10.1038/ajg.2012.212
27. Zhang BL, Jiang LL, Chen CX, Zhong BS, Li YM. Diagnosis of obscure gastrointestinal hemorrhage with capsule endoscopy in combination with multiple-detector computed tomography. J Gastroenterol Hepatol. 2010;25(1):75–79. PMID: 19817955. doi: 10.1111/j.1440-1746.2009.06016.x
28. Huprich JE, Fletcher JG, Fidler JL, et al. Prospective blinded comparison of wireless capsule endoscopy and multiphase CT enterography in obscure gastrointestinal bleeding. Radiology. 2011;260(3):744–751. PMID: 21642417. doi: 10.1148/radiol.11110143
29. Milano A, Balatsinou C, Filippone A, et al. A prospective evaluation of iron deficiency anemia in the GI endoscopy setting: role of standard endoscopy, videocapsule endoscopy, and CT-enteroclysis. Gastrointest Endosc. 2011;73(5):1002–1008. PMID: 21396638. doi: 10.1016/j.gie.2011.01.006
30. Kulkarni C, Moorthy S, Sreekumar K, et al. In the workup of patients with obscure gastrointestinal bleed, does 64-slice MDCT have a role?. Indian J Radiol Imaging. 2012;22(1):47–53. PMID: 22623816. PMCID: PMC3354358. doi: 10.4103/0971-3026.95404
31. Wang Z, Chen JQ, Liu JL, Qin XG, Huang Y. CT enterography in obscure gastrointestinal bleeding: a systematic review and meta-analysis. J Med Imaging Radiat Oncol. 2013;57(3):263–273. PMID: 23721134. doi: 10.1111/1754-9485.12035
32. Wiarda BM, Heine DG, Mensink P, et al. Comparison of magnetic resonance enteroclysis and capsule endoscopy with balloon-assisted enteroscopy in patients with obscure gastrointestinal bleeding. Endoscopy. 2012;44(7):668–673. PMID: 22528671. doi: 10.1055/s-0032-1309386
33. Van Weyenberg SJ, Bouman K, Jacobs MA, et al. Comparison of MR enteroclysis with video capsule endoscopy in the investigation of small-intestinal disease. Abdom Imaging. 2013;38(1):42–51. PMID: 22527155. PMCID: PMC3549405. doi: 10.1007/s00261-012-9892-4
34. Heo HM, Park CH, Lim JS, et al. The role of capsule endoscopy after negative CT enterography in patients with obscure gastrointestinal bleeding. Eur Radiol. 2012;22(6):1159–1166. PMID: 22270143. doi: 10.1007/s00330-011-2374-1
35. Agrawal JR, Travis AC, Mortele KJ, et al. Diagnostic yield of dual-phase computed tomography enterography in patients with obscure gastrointestinal bleeding and a non-diagnostic capsule endoscopy. J Gastroenterol Hepatol. 2012;27(4):751–759. PMID: 22098076. doi: 10.1111/j.1440-1746.2011.06959.x
36. Viazis N, Papaxoinis K, Vlachogiannakos J, Efthymiou A, Theodoropoulos I, Karamanolis DG. Is there a role for secondlook capsule endoscopy in patients with obscure GI bleeding after a nondiagnostic first test?. Gastrointest Endosc. 2009;69(4):850–856. PMID: 18950762. doi: 10.1016/j.gie.2008.05.053
37. Yung DE, Koulaouzidis A, Avni T, et al. Clinical outcomes of negative small-bowel capsule endoscopy for small-bowel bleeding: a systematic review and meta-analysis. Gastrointest Endosc. 2017;85(2):305–317.e2. PMID: 27594338. doi: 10.1016/j.gie.2016.08.027
38. Lindeman RJ, Søreide K. The many faces of Meckel’s diverticulum: update on management in incidental and symptomatic patients. Curr Gastroenterol Rep. 2020;22(1):3. PMID: 31930430. doi: 10.1007/s11894-019-0742-1
39. de Sousa Magalhães R, Cúrdia Gonçalves T, Rosa B, Moreira MJ, Sousa-Pinto B, Cotter J. RHEMITT score: predicting the risk of rebleeding for patients with mid-gastrointestinal bleeding submitted to small bowel capsule endoscopy. Dig Dis. 2020;38(4):299–309. PMID: 31743910. doi: 10.1159/000504385
40. de Sousa Magalhães R, Sousa-Pinto B, Boal Carvalho P, Rosa B, Moreira MJ, Cotter J. RHEMITT score: predicting the risk of mid gastrointestinal rebleeding after small bowel capsule endoscopy: a prospective validation. J Gastroenterol Hepatol. 2022;37(2):310–318. PMID: 34555864. doi: 10.1111/jgh.15695
41. Boortalary T, Erwin R, Dong M, Shinn B, Infantolino A, Tofani C. RHEMITT score predicts rebleed after capsule endoscopy: first validation at a U.S. tertiary care center. Dig Dis Sci. 2023;68(1):187–192. PMID: 35543830. doi: 10.1007/s10620-022-07527-3
42. Liao Z, Gao R, Xu C, Li ZS. Indications and detection, completion, and retention rates of small-bowel capsule endoscopy: a systematic review. Gastrointest Endosc. 2010;71(2):280–286. PMID: 20152309. doi: 10.1016/j.gie.2009.09.031
43. Rezapour M, Amadi C, Gerson LB. Retention associated with video capsule endoscopy: systematic review and meta-analysis. Gastrointest Endosc. 2017;85(6):1157–1168. PMID: 28069475. doi: 10.1016/j.gie.2016.12.024
44. Wang YC, Pan J, Liu YW, et al. Adverse events of video capsule endoscopy over the past two decades: a systematic review and proportion meta-analysis. BMC Gastroenterol. 2020;20(1):364. PMID: 33138792. PMCID: PMC7607645. doi: 10.1186/s12876-020-01491-w
Review
For citations:
Polyakov P.P., Alimetov A.Ya., Onopriev A.V., Avakimyan A.V., Kade A.Kh., Zanin S.A., Zanina E.S., Popov Z.S., Trofimenko A.I., Jndoyan Z.T., Avagimyan A.A. Capsule Endoscopy for the Diagnosis of Suspected Small Bowel Bleeding. Innovative Medicine of Kuban. 2023;(3):121-128. (In Russ.) https://doi.org/10.35401/2541-9897-2023-26-3-121-128