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IMPACT OF NEW TIMING RECOMMENDATIONS FOR CAPSULE ENTEROSCOPY IN THE SETTING OF OVERT DIGESTIVE BLEEDING

Maria Manuela Estevinho 1, Rolando Pinho 1, Adélia Rodrigues 1, Unknown Unknown 1, Joao Paulo Laranjeira Correia 1, Pedro Silva Mesquita 1, Teresa Freitas 1

Affiliations

1 Centro Hospitalar Vila Nova de Gaia Espinho, Vila Nova de Gaia, Porto, Portugal

Summary

AI Generated

Retrospective study of 138 patients with overt middle gastrointestinal bleeding found that capsule enteroscopy performed within 48 hours of admission, as recommended by 2022 ESGE guidelines, was associated with higher therapeutic yield and lower rebleeding rates compared to later timing.

Capsule enteroscopy within 48 hours was significantly associated with higher therapeutic yield (54.0% versus 39.2%, p=0.02) including endoscopic, radiologic, or surgical treatment
Rebleeding rate was significantly lower in patients undergoing enteroscopy within 48 hours (19.5% versus 29.4%, p=0.04)
Diagnostic yield was slightly higher with early capsule enteroscopy (81.6% versus 76.5%, p=0.349) though not statistically significant
Overall mortality at 36 months did not differ between timing strategies (21.8% versus 25.5%, p=0.401)
The study included 138 patients with median age 66 years and median follow-up of 55 months, comparing outcomes when capsule enteroscopy was performed within 48 hours versus later timeframes

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Capsule endoscopy is the first-line examination for digestive bleeding with likely origin in the small bowel, in hemodynamically stable patients. In the 2022 update, ESGE guidelines recommend that, in the context of overt bleeding, capsule enteroscopy should be performed as soon as possible, ideally within the first 48 hours. In the previous guidelines, published in 2015, the recommended window was 14 days.

Aims & Methods

This study aimed to evaluate the improvement in yield offered by the new recommendations regarding the timing of urgent capsule enteroscopy. Patients with suspected overt middle gastrointestinal bleeding between January 2005 and November 2022 were retrospectively analyzed. Diagnostic and therapeutic yield, rebleeding rate, and mortality were compared when capsule enteroscopy was performed within the first 48 hours, within the first 14 days, or between the 3rd and 14th day after admission.

Results

A total of 138 patients were included (58.7% men, median age 66 years), 87 of whom (63.0%) underwent capsule enteroscopy within the first 48 hours after hospital admission. The median follow-up was 55 months (5-180). The diagnostic yield (presence of blood or lesions with bleeding potential) was slightly higher when capsule enteroscopy was performed within the first 48 hours (81.6% versus 76.5%, p=0.349). On the other hand, capsule enteroscopy within the first 48 hours was significantly associated with higher therapeutic yield (endoscopic, radiologic, or surgical treatment) - 54.0% versus 39.2%, p=0.02. The rebleeding rate was significantly lower in patients undergoing enteroscopy within 48 hours after admission (19.5% versus 29.4%, p=0.04). On the other hand, overall mortality at 36 months did not differ between strategies (21.8% and 25.5%, p=0.401).

Conclusion

Performing capsule endoscopy within the first 48 hours, as recommended by recently published guidelines, is associated with favourable short- and long-term clinical outcomes.

Conference

UEG Week Copenhagen 2023

Topics

Small Intestine & Nutrition

Submission format

Abstract

Session

PP 03 Small intestinal (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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