Experience in the Use of Video Capsule Endoscopy in Patients with Unexplained Iron Deficiency Anemia
DOI:
https://doi.org/10.22516/25007440.736Keywords:
Capsule endoscopy, Small intestine lesions, Angiectasias, Iron deficiency anemiaAbstract
Introduction: The prevalence of iron deficiency anemia in developed countries has been estimated between 2-5 %, associated with high morbidity and mortality. Etiological identification is sometimes difficult and requires diagnostic methods, such as video capsule endoscopy (VCE).
Aim: This study intends to characterize the findings of this technique in patients with unexplained iron deficiency anemia.
Materials and methods: Descriptive observational retrospective study. We describe the VCE findings (PillCamSB2-SB3) in all patients seen between 2011 and 2019. The findings were interpreted according to the Saurin classification: normal (P0), uncertain potential (P1), and high bleeding potential (P2).
Results: Of the 490 VCEs performed during the study period, 155 indicated iron deficiency anemia; 106 were women (68.4 %), and the mean age was 57.1 ± 16.6 years. The main comorbidities were cardiovascular in 23 (18.3 %) and arterial hypertension in 16 (12.6 %). Antiplatelets were present in 18 (15.4 %) and anticoagulants in six (5.1 %). Small bowel lesions were vascular in 44 studies (28.4 %), inflammatory in 33 (21.2 %), and neoplastic in seven (4.5 %). Angiectasias were the most frequent lesions in 33 cases (21.3 %). P2 lesions were present in 53 VCEs (34.2 %).
Conclusions: VCE is helpful in the study of iron deficiency anemia and helps detect positive findings in the midgut in three out of four patients for which it is indicated. The most frequent significant P2 lesions were vascular. These findings allow providing adequate treatment.
Downloads
References
Goddard AF, James MW, McIntyre AS, Scott BB; British Society of Gastroenterology. Guidelines for the management of iron deficiency anaemia. Gut. 2011;60(10):1309-16. https://doi.org/10.1136/gut.2010.228874
McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information system, 1993-2005. Public Health Nutr. 2009;12(4):444-54. https://doi.org/10.1017/S1368980008002401
Enns RA, Hookey L, Armstrong D, Bernstein CN, Heitman SJ, Teshima C, et al. Clinical practice guidelines for the use of video capsule endoscopy. Gastroenterology. 2017;152(3):497-514. https://doi.org/10.1053/j.gastro.2016.12.032
Caunedo A, Rodríguez-Téllez M, García-Montes JM, Gómez-Rodríguez BJ, Guerrero J, Herrerías JM Jr, et al. Usefulness of capsule endoscopy in patients with suspected small bowel disease. Rev Esp Enferm Dig. 2004;96(1):10-21. https://doi.org/10.4321/S1130-01082004000100003
Koffas A, Laskaratos FM, Epstein O. Non-small bowel lesion detection at small bowell capsule endoscopy: A comprehensive literature review. World J Clin Cases. 2018;6(15):901-7. https://doi.org/10.12998/wjcc.v6.i15.901
Pérez-Cuadrado-Robles E, Pinho R, Gonzalez B, Mão-de-Ferro S, Chagas C, Esteban Delgado P, et al. Small bowel enteroscopy - A joint clinical guideline from the Spanish and Portuguese small bowel study groups. Rev Esp Enferm Dig. 2020;112(4):309-18. https://doi.org/10.17235/reed.2020.7020/2020
Pérez-Cuadrado-Robles E, Esteban-Delgado P, Martínez-Andrés B, Zamora-Nava LE, Rodrigo-Agudo JL, Chacón-Martínez S, et al. Diagnosis agreement between capsule endoscopy and double-balloon enteroscopy in obscure gastrointestinal bleeding at a referral center. Rev Esp Enferm Dig. 2015;107(8):495-500. https://doi.org/10.17235/reed.2015.3665/2015
Cañadas Garrido R, Rincón Sánchez RA, Costa Barney VA, Roa Ballestas PA, Espinosa Martínez CA, Pinzón Arenas DF, et al. Concordancia diagnóstica entre la videocápsula endoscópica y enteroscopia mono y de doble balón en la hemorragia de intestino delgado en un hospital de alta complejidad en Bogotá, Colombia. Rev Gastroenterol Mex. 2021;86(1):51-8. https://doi.org/10.1016/j.rgmx.2020.03.004
Min YW, Chang DK. The role of capsule endoscopy in patients with obscure gastrointestinal bleeding. Clin Endosc. 2016;49(1):16-20. https://doi.org/10.5946/ce.2016.49.1.16
Juliao Baños F, Muñoz Ortiz E, Yepes Delgado CE. Rendimiento diagnóstico y hallazgos de cápsula endoscópica en pacientes con sangrado digestivo de origen oscuro en el Hospital Pablo Tobón Uribe en Medellín - Colombia. Rev Col Gastroenterol. 2013;28(2):114-23.
González-Suárez B, Galter S, Balanzó J. Cápsula endoscópica: fundamentos y utilidad clínica. Cir Esp. 2007;81(6):299-306. https://doi.org/10.1016/S0009-739X(07)71328-3
García del Risco F, Arrieta López E. Rendimiento diagnóstico y hallazgos con la cápsula endoscópica en pacientes con sangrado digestivo de origen oscuro en la Clínica Universitaria San Juan de Dios en Cartagena, Colombia. Rev Col Gastroenterol. 2014;29(2):101-11.
Pons Beltrán V, Carretero C, González-Suárez B, Fernández-Urien I, Muñoz-Navas M. Intestinal preparation prior to capsule endoscopy administration. World J Gastroenterol. 2008;14(37):5773-5. https://doi.org/10.3748/wjg.14.5773
Pons Beltrán V, González Suárez B, González Asanza C, Pérez-Cuadrado E, Fernández Diez S, Fernández-Urién I, et al. Evaluation of different bowel preparations for small bowel capsule endoscopy: A prospective, randomized, controlled study. Dig Dis Sci. 2011;56(10):2900-5. https://doi.org/10.1007/s10620-011-1693-z
Rodina J, Derovs A, Derova J, Pokrotnieks J. The small bowel video capsule endoscopy - Ten years’ experience in Latvia. Eksp Klin Gastroenterol. 2016;(11):39-47.
Saurin JC, Delvaux M, Gaudin JL, Fassler I, Villarejo J, Vahedi K, et al. Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push enteroscopy. Endoscopy. 2003;35(7):576-84. https://doi.org/10.1055/s-2003-40244
Spada C, McNamara D, Despott EJ, Adler S, Cash B, Fernández-Urién I, et al. Performance measures for small-bowel endoscopy: A European society of gastrointestinal endoscopy (ESGE) quality improvement initiative. United European Gastroenterol J. 2019;7(5):614-41. https://doi.org/10.1177/2050640619850365
Apostolopoulos P, Liatsos C, Gralnek IM, Giannakoulopoulou E, Alexandrakis G, Kalantzis C, et al. The role of wireless capsule endoscopy in investigating unexplained iron deficiency anemia after negative endoscopic evaluation of the upper and lower gastrointestinal tract. Endoscopy. 2006;38(11):1127-32. https://doi.org/10.1055/s-2006-944736
Triester SL, Leighton JA, Leontiadis GI, Fleischer DE, Hara AK, Heigh RI, et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding. Am J Gastroenterol. 2005;100(11):2407-18. https://doi.org/10.1111/j.1572-0241.2005.00274.x
Mosquera-Klinger GA, Camargo Trillos J, Gómez Ramírez LA, Bustamante Duque M, Carvajal Gutiérrez JJ. Experiencia con videocápsula endoscópica en el estudio y diagnóstico de enfermedades del intestino delgado en un hospital de alta complejidad en Medellín, Colombia. Rev Colomb Gastroenterol. 2018;33(4):386-92. https://doi.org/10.22516/25007440.223
Xavier S, Magalhães J, Rosa B, Moreira MJ, Cotter J. Impact of small bowel capsule endoscopy in iron deficiency anemia: Influence of patient’s age on diagnostic yield. Arq Gastroenterol. 2018;55(3):242-6. https://doi.org/10.1590/s0004-2803.201800000-61
Sidhu PS, McAlindon ME, Drew K, Sidhu R. The utility of capsule endoscopy in patients under 50 years of age with recurrent iron deficiency anaemia: Is the juice worth the squeeze? Gastroenterol Res Pract. 2015;2015:948574. https://doi.org/10.1155/2015/948574
Muhammad A, Vidyarthi G, Brady P. Role of small bowel capsule endoscopy in the diagnosis and management of iron deficiency anemia in elderly: A comprehensive review of the current literature. World J Gastroenterol. 2014;20(26):8416-23. https://doi.org/10.3748/wjg.v20.i26.8416
Pérez-Cuadrado-Robles E, Zamora-Nava LE, Jiménez-García VA, Pérez-Cuadrado-Martínez E. Indicaciones y rendimiento diagnóstico de la cápsula endoscópica en el anciano. Rev Gastroenterol Mex. 2018;83(3):238-44. https://doi.org/10.1016/j.rgmx.2017.08.004
Olano C, Pazos X, Avendaño K, Calleri A, Ketzoian C. Diagnostic yield and predictive factors of findings in small-bowel capsule endoscopy in the setting of iron-deficiency anemia. Endosc Int Open. 2018;6(6):688-93. https://doi.org/10.1055/a-0593-5915
Contaldo A, Losurdo G, Albano F, Iannone A, Barone M, Ierardi E, et al. The spectrum of small intestinal lesions in patients with unexplained iron deficiency anemia detected by video capsule endoscopy. Medicina (Kaunas). 2019;55(3):59-68. https://doi.org/10.3390/medicina55030059
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):280-6. https://doi.org/10.1016/j.gie.2009.09.031
Riccioni ME, Urgesi R, Spada C, Cianci R, Pelecca G, Bizzotto A, et al. Unexplained iron deficiency anaemia: Is it worthwhile to perform capsule endoscopy? Dig Liver Dis. 2010;42(8):560-6. https://doi.org/10.1016/j.dld.2010.01.023
Downloads
Published
How to Cite
Issue
Section
License
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
Los autores/as ceden sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación en esta revista.
Los contenidos están protegidos bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
