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

R. Cañadas Garrido, R.A. Rincón Sánchez, V.A. Costa Barney, P.A. Roa Ballestas, C.A. Espinosa Martínez, D.F. Pinzón Arenas, R. Ramirez Barranco
2020 Revista de Gastroenterología de México  
Video capsule endoscopy and balloon-assisted enteroscopy are complementary diagnostic methods in the study of small bowel bleeding, and different factors can affect their diagnostic yield. To define the level of agreement between video capsule endoscopy and enteroscopy in small bowel bleeding, according to the type of lesion, in a cohort of patients at a tertiary care referral center. A retrospective study was conducted that included 428 capsule endoscopies performed within the time frame of
more » ... 1 and 2019 at our healthcare institution. Seventy-four video capsule endoscopies, followed by enteroscopy, in 71 patients suspected of presenting with small bowel bleeding, were analyzed. Mean patient age was 63.9 ± 13.5 years and 42 patients were women. The two diagnostic procedures were performed. Overall diagnostic yield of positive findings between video capsule endoscopy and enteroscopy was 86.5% vs. 58.1%, respectively (p = 0.0527). Agreement between video capsule endoscopy and enteroscopy for positive pathologic findings was weak (Ik = 0.17, 95% CI: -0.0097-0.3543), but according to lesion type, it was good for inflammatory lesions (Ik = 0.71, 95% CI: 0.5182-0.9119) and moderate for angiectasias (Ik = 0.45, 95% CI: 0.2469-0.6538) and tumors (Ik = 0.40, 95% CI: 0.1217-0.6794). The results between the two methods differed in 38 patients (51.3%). There was complete intestinal capsule retention in one patient (1.4%) and active bleeding in 13 (17.6%). The present study showed that the two techniques had a similar overall detection rate for small bowel lesions, but the type of lesion was the main factor that could modify diagnostic agreement.
doi:10.1016/j.rgmx.2020.03.004 pmid:32499179 fatcat:35kv57nkmzaunl2cay2xigg4zi