Result of wireless capsule endoscopy in patients with suspected small bowel disease: the first series from Thailand.

ABSTRACT

BACKGROUND AND AIMS: Capsule endoscopy (CE) is a promising diagnostic tool for patients with obscure gastrointestinal bleeding. Only a few papers have reported data from Asian countries. This retrospective study aimed to demonstrate result of capsule endoscopy in patients with suspected small bowel disease as the first series from Thailand. METHOD: Twenty-one patients who underwent wireless capsule endoscopy between July 2003 and June 2004 at King Chulalongkorn Memorial Hospital were retrospectively reviewed in the present study. The indications for capsule endoscopy were overt obscure gastro-intestinal bleeding (n= 12), occult obscure gastro-intestinal bleeding (n=5), chronic recurrent abdominal pain (n=3) and chronic diarrhea (n=1). Diagnoses according to findings of capsule endoscopy were classifield into definite, suspicious and negative finding. RESULTS: The mean age of the 21 patients (10 men and 11 women) was 46 (standard deviation, 18.57) years. Of those 17 obscure gastrointestinal bleeding patients, there were positive findings in 11 from 17 patients (65%). Four patients (24%), 3 with tumor and another with AVM, were classified as definite results. Seven patients (41%), 6 with angioectasia and another with a small ulcer, were classified as suspicious because there was no demonstrated active bleeding lesion and no other clinical supportive evidence. Of these 3 patients with recurrent abdominal pain, one patient (33%) with terminal ileum lymphoid hyperplasia was classified as definite result because of clinical improvement after treatment of the lesion. Another case of chronic diarrhea yielded a negative result. CONCLUSION: Wireless capsule endoscopy is a safe and useful mode of investigation for the diagnosis of obscure gastrointestinal bleeding in Thailand. There is not so much difference in capsule endoscopy results between Western and Asian series.