Wireless capsule endoscopy – A new tool for investigation of suspected gastrointestinal bleeding

Aims: To retrospectively review the use of Wireless Capsule Endoscopy (WCE) following negative colonoscopy and oesphagoduodenoscopy in suspected gastrointestinal bleeding.

Methods: Data was obtained from WCE soft copy reports of 54 patients who had had WCE over an 18 month period. 31 patients were identified who were referred for suspected GI bleeding. Referral patterns were reviewed and the group was divided into 3 categories – severe bleeders, overt bleeders and covert bleeders. Severe bleeders were defined as those whose anaemia had necessitated more than one blood transfusion. Overt bleeders were those who had melaena, haematemsis or blood per rectum. Covert bleeders were those patients referred with iron deficiency anaemia alone.

Results: The diagnostic yields in the severe bleeder group, the overt bleeder group and covert bleeder group were 75%, 60% and 25% respectively.

Conclusions: Wireless capsule endoscopy is useful for the assessment of overt GI bleeding and also in the investigation of severe anaemia requiring repeated blood transfusions. The diagnostic yield in iron deficiency anaemia was low in this review and the role of WCE is less clear.