Diagnosis of Obscure Gastrointestinal Bleeding: Capsule Endoscopy or Double Balloon Enteroscopy?

摘要

The development of capsule endoscopy (CE) and double balloon enteroscopy (DBE) has significantly enhanced the visualization of the small bowel. CE and DBE have proven to be the choice of investigation for the diagnosis of small bowel disease and is an evident indication for obscure gastrointestinal bleeding (OGIB). CE or DBE respectively are frequent option of professionals for the diagnosis of obscure gastrointestinal bleeding. The purpose of this review is to provide an overview of studies focused on patients with obscure gastrointestinal bleeding with previous CE and/or DBE intervention. Studies show that CE and DBE have similar diagnostic yields for obscure gastrointestinal bleeding. Although with few chances for false negative results, most researches showed good concordance between CE and DBE. However due to its non-invasiveness, safety, patient tolerability and ability to view the entire small bowel, CE can be recommended as a first choice of investigation. DBE, despite being more invasive, is a necessary second choice, which has both diagnostic and therapeutic value, although skilled endoscopist and sedation are required and complications like bleeding, perforation, pancreatitis etc. may occur.