ABSTRACT
Objective: capsule endoscopy [CE] has revolutionized the evaluation of small bowel disorders, particularly obscure gastrointestinal bleeding [OGIB]. The aim of this study was to determine the findings and the diagnostic yield of CE in a large series of patients with suspected small bowel disease mainly OGIB; as well as to compare our results to that of other reported centers
Methods: data on 230 patients who underwent capsule endoscopy for suspected small bowel related symptoms and/ or signs mainly overt [81 patients] or occult [66 patients] OGIB were obtained by retrospective chart review and review of an internal computer database of capsule endoscopy patients. Data presented as percentages, p value used to show differences whenever relevant
Results: out of 230 patients investigated for small bowel related symptoms and /or signs, 7 patients excluded mainly due to improper preparation, of the remaining 223, 128 [57.3%] had some lesion detected by CE,80 [35.8%] had definite lesions detected that could unequivocally explain patients' complaints. Patients with overt GI bleeding had the highest diagnostic yield [64.1%], this was significantly greater [P < 0.001] compared to that in patients with occult bleeding [43.9%] as well as those with abdominal pain and/or diarrhea [33.3%]. Angiodysplasia is the most common cause of OGIB [26.5%]
Conclusions: the yield of clinically important findings on CE in patients with OGIB is 55% and is greater in patients with obscure-overt than obscure-occult GI bleeding. Angiodysplasia account for the majority of significant lesions in both groups
ABSTRACT
Primary intestinal lymphangiectasia is a rare disorder that is not commonly associated with autoimmune phenomena. We report a case of a 29-year-old man with primary lymphangiectasia who additionally had vitiligo, autoimmune hypothyroidism, hypogonadism, and pernicious anemia. We speculate that autoimmunity may play a role in the pathogenesis of primary intestinal lymphangiectasia