Capsule Endoscopy or Mesenteric Angiogram in Patients With Overt Gastrointestinal Bleeding (GIB) of Obscure Origin

Chinese University of Hong Kong58 enrolled

Overview

To compare the diagnostic yield of mesenteric angiogram with CE in patients with active obscure GIB.

Gastrointestinal bleeding (GIB) of obscure origin is a common conditions resulting in recurrent hospitalization and extensive investigations. Mesenteric angiogram is one of the standard radiological investigations for GIB of obscure origin, and its diagnostic yield ranged from 40-80%. Capsule endoscopy (CE) is a newly available investigation for small bowel examination, especially in bleeding of obscure origin. The diagnostic yield is particularly high in patients with ongoing bleeding. This is a prospective randomized study to compare the diagnostic yield of mesenteric angiogram with CE in patients with overt GIB of obscure origin. The results will help to define the optimal management strategy for this group of patients.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

Conditions

Gastrointestinal Hemorrhage

Interventions

capsule endoscopyPROCEDURE

capsule endoscopy of small intestine

Mesenteric AngiogramPROCEDURE

Mesenteric Angiogram

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * All patients admitted to PWH medical or surgical wards with melena or hematochezia in whom OGD and colonoscopy fail to identify site of bleeding. * Normal or non-diagnostic OGD and colonoscopy * Informed consent * Patients presented with shock will be resuscitated for urgent endoscopy Exclusion Criteria: * Patients remained in shock despite resuscitation. * Moribund patients * Terminal malignancy * Presence of pacemaker or ICD * Suspected or confirmed intestinal obstruction * Swallowing difficulties * Renal failure that preclude angiographic examination * Pregnancy * Age \<18 * Refused consent

Locations (1)

Endoscopy Center, Prince of Wales Hospital

Hong Kong(SAR), China

Outcomes

Primary Outcomes

Diagnostic yield of CE and mesenteric angiogram as the primary investigation after negative EGD and colonoscopy.

Time frame: 12 months

Secondary Outcomes

Percentage of patients with definitive diagnoses achieved;Length of stay (days) ;Transfusion requirements;No. of additional investigations (endoscopies, radiological investigation, CE etc);No. of patients requiring surgery ;12-month rebleeding rate

Time frame: 12 months

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.