INDICATIONS AND DIAGNOSTIC YIELD OF SMALL BOWEL ENDOSCOPY: ANALYSIS OF A LARGE, REAL-WORLD, DATABASE FROM A TERTIARY REFERRAL CENTER IN GREECE

Aims Small bowel capsule endoscopy (SBCE) is a valuable diagnostic tool used for a variety of clinical indications. Using a large database, we aimed at evaluating indications and diagnostic yield of SBCE in a real-world setting.

Methods Retrospective analysis of prospectively collected data, including all patients who underwent SBCE over a 18-year period (3/2003-11/2021). Depending on the indication, patients were divided into 3 groups: group A=investigation of obscure gastrointestinal bleeding (overt or occult), group B=investigation of patients with diagnosed or probable Crohn's disease and group C=all other indications. Diagnostic yield was defined as tests with positive findings that could explain the patient's symptoms and the indication for SBCE referral.

Results Overall, 7501 patients were included (men/women: 3860/3641, mean age±SD: 52.6±27.3 years). The most common indication was obscure gastrointestinal bleeding (group A, n=4012, 53.4%) followed by diagnosed or probable Crohn’s disease (group B, n=2557, 34.1%) and all other indications (group C, n=932, 12.4%). The diagnostic yield of SBCE was 40.4% for group A, 63.4% for group B and 26.4% for group C. The most common finding in group A was angiodysplasia (n=1253, 31.2%), in group B lesions compatible with Crohn's disease (n=1392, 54.4%) and in group C ulcers from aspirin and NSAIDs (n=91, 9.7%).

Conclusions Indications of SBCE in a real-world setting are largely consistent with current guidelines. The diagnostic yield of SBCE varies considerably depending on the indication, ranging from 26% to 63%.

Publication History

Article published online:
14 April 2022