The Clinical Value Of Capsule Endoscopy In The Diagnosis Of Obscure Gastrointestinal Bleeding

Objective: To analysis of capsule endoscopy in diagnosis of obscuregastrointestinal bleeding(OGIB) clinical application value.Methods:The study retrospectively analyzed a total of43OGIBpatients undergone capsule endoscopy in China-Japan Union Hospitalfrom February2009to December2014., and make a careful analysis ofthe images of the capsule endoscopy. Respectively calculate capsuleendoscopy in patients with normal and abnormal results in averagethrough the stomach and small intestine, the average working time andthe number of picture frames, the rate of passing ileocecal valve withinthe effective time,evaluate the safety of capsule endoscopy, patient’stolerance and complications, calculate positive rate, suspicious positiverate,negative rate and the rate of detecting lesions, follow up thesurgical patients with positive results of capsule endoscopy and theirpostoperative pathological results, compare with the positive rate of totalabdominal CT.Results:capsule endoscopy in patients with normal and abnormalresults results in average through the stomach were（14.5±6.1）min、（14.9±8.9）min the average small intestinal transit time were（306.3±88.5）min、（298.1±78.6)min, there were no significant differencesbetween the two results(P>0.05).2,43cases of capsule endoscopy results, capsule working time4h25min/case-8h12min/cases,6h13minon average, there are16400-19800frames in each case,17700frames/case on average3. In43patients,6had not reached ileocecalvalve，the rate of passing ileocecal valve within the effective time wasabout86.0%, of which three capsules were stuck in the small intestinebecause of narrow lumen, no adverse reactions associated with thecapsule happened,6cases stayed in the stomach for a long time，thecapsules were pushed into the duodenum by gastroscope.4. the results ofcapsule endoscopy:(1)21positive results (48.8%),2cases of smallintestine diverticulum (4.7%),3cases of small intestinal tumors (7.0%),3cases of Crohn’s disease (7.0%),4cases of vascular malformation(9.3%),9cases of small intestinal ulcer (20.9%).(2)10cases ofsuspected positive diagnosis (23.2%),6cases of small enteritis (14.0%)(mucosal hyperemia, erythema, mild erosion, etc.),4cases of intestinalpolyps (9.2%).(3)12cases of negative results (28.0%).(4) The rate ofdetecting lesions was72.0%.(5)7surgical patients with positive resultsof capsule endoscopy included2cases of small intestinal diverticulum,3cases of small intestinal tumor,2cases of Crohn’s disease, the results ofcapsule endoscopy were in agreement with the postoperative pathologicresults.(6) The results of6cases with abdominal CT examination werepositive, in agreement with the results of capsule endoscopy, the rate ofdetecting lesions was14.0%, lower than the rate of capsule endoscopy, there were statistical differences between the two results (P <0.01).Conclusion:The diagnosis rate of obscure gastrointestinal bleedingis high by capsule endoscopy,the detection rate of capsule endoscopy ishigher than the detection rate of abdominal CT,Capsule endoscopy issecure, with fewer complications, can be easily tolerant by patients.