A Prospective Study Comparing Real Time Video Capsule Endoscopy to Standard Endoscopy in Patients with Suspected Upper Gastrointestinal Bleeding

To determine the diagnostic yield, quality of risk stratification, andpatient tolerability of real time video capsule endoscopy (RT-VCE)as compared to standard upper endoscopy and official video capsuleendoscopy (O-VCE) in patients presenting with UGIB. A total of 20patients were evaluated during our trial period. An official interpretationof the VCE (O-VCE) was performed by an experienced endoscopistand documented before the end of the day. Overall cumulativefindings and their clinical significance were evaluated using the RTVCEand O-VCE interpretations as compared to gold standard EGD.The level of agreement in individual re-bleeding risk was comparedusing EGD versus VCE obtained Rockall scores. A questionnaireon patient tolerability and satisfaction was administered after bothprocedures were completed. Prospective analysis revealed that EGDand RT-VCE identified both low acuity and high acuity lesion atstatistically similar rates (79% vs. 68%, p=0.157, and 21% vs. 32%,p=0.157 respectively). There was high level of agreement betweenthe post endoscopy Rockall scores obtained for RT-VCE, O-VCEand EGD (Spearman correlation coefficient of 0.97 and 0.86 respectively,p<0.0001). Real time capsule endoscopy was the self reportedpreferable diagnostic test of choice. RT-VCE has similar lesion detectionrates when compared to both standard EGD and O-VCE, andmay serve as a risk stratification tool in patients who present withsuspected UGIB, and are at high risk for cardiopulmonary complicationsfrom EGD.