Diagnostic Value Of Capsule Endoscopy And CT Enteroclysis For Obscure Gastrointestinal Bleeding

Objectives:To investigate the diagnostic value of capsule endoscopy(CE)and CT enteroclysis(CTE)for obscure gastrointestinal bleeding(OGIB).Methods:We retrospectively analyzed the data from 70 patients with OGIB who underwent capsule endoscopy and CT enteroclysis between January 2011 and June 2016 at the First Affiliated Hospital of Nanjing Medical University in China.The detection rates,the rates of diagnosis in the causes of OGIB and diagnosis coincidence were analyzed in 70 patients with OGIB.Results:The overall detection rate of OGIB by capsule endoscopy was much higher than that by CT enteroclysis(90.00%vs 22.86%,P=0.000),the diagnosis rate in the cause of OGIB was 61.43%by capsule endoscopy and 10.0%by CT enteroclysis,the former is obviously higher than the latter(P=0.000).The diagnosis coincidence between CE and CTE was only 27.14%.The overall detection rate and diagnosis rate in cause of OGIB by capsule endoscopy combination with CT enteroclysis were slightly superior to capsule endoscopy,but there was no significance(P>0.05).The overall detection rate by capsule endoscopy in patients with overt bleeding was higher than that in patients with occult bleeding,while no significant difference was found by CT enteroclysis(P=0.854).The similar results were also found in the comparison of diagnostic rate between overt bleeding and occult bleeding(P=0.809 and P=0.833).The findings of vascular lesions,erosion/ulcer and diverticulum by capsule endoscopy were superior to that of CT enteroclysis.Although the diagnosis of Crohn's disease,polyps,small bowel bleeding and parasitic disease by Capsule endoscopy was superior to that by CT enteroclysis,there was no significance.For patients with OGIB,the CE detection was negative,the tumors in small intestine were found by CTE examination,which were confirmed by surgery(2 patients with negative result by CE,but CTE showed tumor in small intestine).Conclusion Both Capsule endoscopy and CT enteroclysis are safe and effective methods in diagnosing OGIB.The diagnostic rate of the capsule endoscopy in OGIB was significantly higher than that by CT enteroclysis.Although the value of CE combined with CTE was not superior to CE alone,it may be complimentary in some cases,especially in diagnosis of small intestinal tumor.