Authors: Andrea C Rodriguez Ashok Shiani Seth Lipka Kirbylee K Nelson Ashley H DavisYadley Roshanak Rabbanifard Ambuj Kumar Patrick G Brady
Publish Date: 2015/07/30
Volume: 60, Issue: 12, Pages: 3716-3720
Abstract
Within the community patients with positive capsule endoscopy CE are often referred to centers performing balloonassisted enteroscopy There is limited data evaluating the concordance and diagnostic/therapeutic yield of CE performed in the community versus CE conducted at institutions experienced with enteroscopy The primary aim of this retrospective study was to evaluate the concordance between CE and SBE after CE was performed either in the community or at our tertiary care centerA total of 141 patients were analyzed after selecting patients undergoing evaluation of obscure GI bleeding from January 2010 to May 2014 Fortyseven CE were performed inside and the remaining 94 CE were performed at outside institutions prior to singleballoon enteroscopy at our institution Agreement beyond chance was evaluated using kappa coefficient A p value 5 was considered significantThe most frequent findings on CE were vascular lesions in 39 patients 415 within the referral group and 23 within inside patients 489 followed by active bleeding/clots in 23 patients 245 and in 14 patients 298 respectively There was a fair degree of concordance in the referral group for vascular lesions 023 003–042 compared to a good degree in the inside group 065 044–087 Fair agreement was found looking at ulcers within the referral group 029 006–065 compared to a moderate agreement in the inside group 055 017–094Degree of concordance for vascular lesions and ulcers was significantly higher for patients undergoing CE at our institution compared to those referred from the community Patients referred to tertiary care centers for balloonassisted enteroscopy may benefit from advanced endoscopists rereading the capsule findings or even potentially repeating CE in hemodynamically stable patients if the study is not available
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