El papel de la videocápsula endoscópica en la hemorragia digestiva / The role of the endoscopic videocapsule in digestive hemorrhage

RESUMEN

Introducción: desde el advenimiento de la cápsula endoscópica, la hemorragia digestiva del intestino delgado ha cambiado su epidemiología y se ha podido identificar diversas causas que antes no se las entendía. Este estudio enmarca nuestra experiencia en esta nueva técnica de gran utilidad en el Hospital Metropolitano para estudiar el sangrado del intestino delgado. Objetivo: determinar los hallazgos identificados por cápsula endoscópica y su utilidad en los 3 grupos de hemorragia digestiva del intestino delgado que son 1) sangrado evidente, 2) sangrado oculto y 3) anemia ferropénica. Metodología: se realizó un estudio descriptivo retrospectivo transversal. Se revisaron 201 historias clínicas de las cuales se seleccionaron aquellas cuyos pacientes acudían a realizarse un estudio de cápsula endoscópica debido a sospecha de sangrado digestivo del intestino delgado. Variables que se analizaron edad, sexo, hallazgos y una variable de utilidad del estudio en el sangrado digestivo. El sistema de la cápsula endoscópica que se utilizó fue Pill Cam 2 de la GIVEN de intestino delgado. Resultados: distribución etaria promedio de 58±17 años (56% menores de 65 años y 44% mayores de 65 años). Las causas de sangrado del intestino delgado de los 3 grupos estudiados fue angiodisplasia (9%), múltiples erosiones (8%), tumores del intestino delgado erosionados (5%). La cápsula endoscópica para detectar la etiología de sangrado digestivo fue útil en 84% de los casos sangrado evidente (85%), en el grupo de anemia (84%) y en el grupo de sangrado oculto (85%). Conclusión: la hemorragia digestiva del intestino delgado se puede presentar en cualquier edad y sexo. Los hallazgos más frecuente de hemorragia del intestino delgado son las angiodisplasias, las cuales se relacionan con la edad y múltiples erosiones de la mucosa intestinal. La cápsula endoscópica es un método de gran utilidad para detectar la detección etiología de la hemorragia de intestino delgado. (AU)

ABSTRACT

Introduction: Since the advent of the endoscopic capsule, digestive hemorrhage of the small intestine has changed in its epidemiology and it has been possible to identify several causes not previously understood. This study frames our experience in this new technology at the Metropolitan Hospital in the study of small bowel bleeding and its great utility. Objective: The objective of the study was to determine the findings identified by endoscopic capsule and its usefulness in the three groups of digestive hemorrhage of the small intestine, that are evident bleeding, occult bleeding and iron deficiency anemia. Methodology: A transversal retrospective descriptive study was carried out. In the study, 201 clinical records of patients were reviewed and those who attended an endoscopic capsule study with suspicion of digestive bleeding of small bowel origin were selected. The variables analyzed were age, sex, findings and a useful variable of the study in digestive bleeding. The system of the endoscopic capsule that was used was the Pill Cam 2 of the GIVEN of small intestine. Results: Among the results, an average age distribution of 58±17 years of age was found, of which 56% were patients under 65 years of age and 44% were older than 65 years. The most frequent cause of bleeding in the small intestine of the three groups studied was angiodysplasias in 9%. Multiple erosions were found in 8% of the patients. The presence of erosionaded small bowel tumors was observed in 5%. The endoscopic capsule in the detection of causes of digestive bleeding was useful in determining the etiology in 84% of cases. In the evident bleeding it was useful in 85%, in the anemia group 84% and in the group of occult bleeding in 85%. Conclusion: Small intestine digestive hemorrhage can occur at any age and in any gender. The most common findings of small bowel hemorrhage are angiodysplasias that are related to age, as well as multiple erosions of the intestinal mucosa. The endoscopic capsule is a very useful method in the etiological detection of small bowel hemorrhage. (AU)