Magnetic assisted capsule endoscopy is effective for the assessment of upper gastrointestinal bleeding, according to study results.
Hey-Long Ching, MBBS, BSc, MRCP, of the academic department of gastroenterology and hematology at Royal Hallamshire Hospital in the United Kingdom, and colleagues wrote in Gastrointestinal Endoscopy, that esophagogastroduodenoscopy (EGD) is the standard technique for assessing suspected upper GI bleeding, but it can still miss lesions.
“Capsule endoscopy is a first-line small-bowel investigation,” they wrote. “It has also been used to assess esophageal disease and may have a role in acute upper GI bleeding as a risk-stratifying tool.”
Researchers conducted a prospective cohort study to compare the diagnostic yield of magnetic assisted capsule endoscopy (MACE) with EGD in patients with suspected upper GI bleeding. They also explored patient tolerance, mucosal visibility and frequency of small bowel bleeding as secondary outcomes. They also wanted to determine if MACE could safely predict patient discharge and avoid unnecessary EGD or hospital admission. Patients (n = 33) underwent MACE one hour before EGD.
Investigators found that MACE detected more focal lesions — including peptic, vascular and fresh or altered blood without a clear source — than EGD (40 vs. 24; P = .02), and achieved similar efficacy in detecting significant lesions that were considered to be source of blood (14 vs. 13).
Visualization by MACE was “excellent” in most areas, except for suboptimal views of the esophagus, gastroesophageal junction, fundus and duodenal bulb. Researchers found that MACE was also able to identify additional cause for bleeding in the small bowel in 18% of cases.
Ching and colleagues wrote that MACE was better tolerated than EGD and identified 24 patients as potentially safe for discharge. Researchers concurred with those discharge decisions after comparing with findings from EGD.
“MACE detects more upper GI lesions and appears to be comparable with EGD in the detection of lesions suspected as being the cause of bleeding, although both modalities miss pathologies,” they wrote. “Further randomized control studies and economic analyses are required to determine whether magnetically assisted capsule endoscopy has a role as a diagnostic alternative or a risk-stratifying tool to avoid hospital admission in this cohort.” – by Alex Young
Disclosures: Ching reports no relevant financial disclosures. Please see the full study for all other authors’ relevant financial disclosures.