Immediate capsule endoscopy or angiogram in patients with acute obscure gastrointestinal bleeding: A prospective randomized study with long term follow up

Abstract

OBJECTIVE: The initial investigation for patients with acute obscure gastrointestinal bleeding (OGIB) remains poorly defined. We compared the diagnostic yield and long term outcome of patients with acute overt OGIB randomized to immediate capsule endoscopy (CE) or angiogram. Design: This is a prospective randomized study that compared CE with angiogram in patients with acute overt OGIB. Consecutive patients presented with acute melena or hematochezia but non-diagnostic upper and lower endoscopy were immediately randomized to receive small bowel CE or angiogram. Those who developed ongoing bleeding during the same admission were crossed over to the other modality. All patients were monitored for rebleeding and recurrent anemia for up to 5 years. Primary endpoint was the diagnostic yield of the assigned investigation. Secondary endpoints included long term rebleeding, further transfusion, readmission for bleeding and …