Using capsule endoscopy to identify GI tract lesions in cirrhotic patients with portal hypertension and chronic anemia.

Journal Article

GOALS: We aimed to evaluate the ability of capsule endoscopy (CE) to detect small intestine (SI) lesions, especially SI varices, in patients with intrahepatic cirrhosis, portal hypertension (PHTN), and chronic anemia. BACKGROUND: Gastroesophageal variceal bleeding is a well-recognized complication of cirrhosis and PHTN, yet methods of identifying lesions in the SI that may contribute to covert bleeding and anemia, such as small bowel enteroscopy and angiography, are invasive and may be inadequate. STUDY: In this observational pilot study, 19 consecutive patients presenting to a tertiary care, liver transplantation referral center with cirrhosis, PHTN, and chronic anemia after obliterative esophageal variceal therapy were evaluated with wireless CE using the GIVEN Pillcam SB M2A capsule. Two independent and blinded examiners reviewed the CE examinations. RESULTS: SI varices were identified in 15.8% (3/19) of patients. Other PHTN-related findings included portal hypertensive gastropathy (13/19, 68.4%), portal hypertensive enteropathy (12/19, 63.1%), and portal hypertensive colopathy (3/19, 15.8%). Two patients had nonbleeding esophageal varices (2/19, 10.5%). A potential source of gastrointestinal blood loss was identified in 89.5% (17/19) of patients. Active bleeding sites were identified in 15.8% (3/19). CONCLUSIONS: CE can identify potential bleeding sources and could have diagnostic utility in patients with end-stage liver disease and chronic anemia after obliterative esophageal variceal therapy.

Full Text

Duke Authors

Cited Authors

  • Canlas, KR; Dobozi, BM; Lin, S; Smith, AD; Rockey, DC; Muir, AJ; Agrawal, NM; Poleski, MH; Patel, K; McHutchison, JG

Published Date

  • August 2008

Published In

Volume / Issue

  • 42 / 7

Start / End Page

  • 844 - 848

PubMed ID

  • 18277884

Electronic International Standard Serial Number (EISSN)

  • 1539-2031

Digital Object Identifier (DOI)

  • 10.1097/MCG.0b013e318038d312

Language

  • eng

Conference Location

  • United States