Original Article
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Positive Fecal Occult Blood Test is a Predictive Factor for Gastrointestinal Bleeding after Capsule Endoscopy in Patients with Unexplained Iron Deficiency Anemia: A Korean Multicenter CAPENTRY Study
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Ji Young Chang, Chang Mo Moon, Ki-Nam Shim, Dae Young Cheung, Hyun Seok Lee, Yun Jeong Lim, Seong Ran Jeon, Soo Jung Park, Kyeong Ok Kim, Hyun Joo Song, Hyun Joo Jang, Ji Hyun Kim
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Clin Endosc 2020;53(6):719-726. Published online November 6, 2020
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DOI: https://doi.org/10.5946/ce.2019.149
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Abstract
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- Background
/Aims: Capsule endoscopy (CE) is recommended as the primary method for the evaluation of unexplained anemia. This study aimed to assess the diagnostic yield of CE in patients with unexplained iron deficiency anemia (IDA) without overt bleeding, and to evaluate their long-term outcomes and related clinical factors.
Methods
Data of patients who underwent CE for the evaluation of IDA were reviewed from a CE registry in Korea. Additional clinical data were collected by the involved investigators of each hospital through a review of medical records.
Results
Among a total of 144 patients, the diagnostic yield of CE was 34%. Gastrointestinal (GI) bleeding was found in 6.3% (n=9) of the patients (occult bleeding in four patients and overt bleeding in five patients) during a mean follow-up of 17.8 months. Patients with a positive fecal occult blood test (FOBT) result at the initial diagnosis had a higher rate of GI bleeding after CE (p=0.004). In addition, a positive FOBT result was the only independent predictive factor for GI bleeding (hazard ratio, 5.30; 95% confidence interval, 1.41–19.85; p=0.013).
Conclusions
Positive FOBT is a predictive factor for GI bleeding during follow-up after CE in patients with unexplained IDA without overt bleeding. Thus, patients with positive FOBT need to be more closely followed up.
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Citations
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Marco Pennazio, Emanuele Rondonotti, Edward J. Despott, Xavier Dray, Martin Keuchel, Tom Moreels, David S. Sanders, Cristiano Spada, Cristina Carretero, Pablo Cortegoso Valdivia, Luca Elli, Lorenzo Fuccio, Begona Gonzalez Suarez, Anastasios Koulaouzidis,
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Shadi Hamdeh, Jihan Fathallah, Hui Zhang, Amber Charoen, Barakat Aburajab Altamimi, Florence-Damilola Odufalu, Devashree Dave, Amer El Sayed, Laura R. Glick, Scott Grisolano, Christine Hachem, Muhammad Bader Hammami, Khaldoun Haj Mahmoud, Alexander N. Lev
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Wonshik Kim, Beomjae Lee, Ahyoung Yoo, Seunghan Kim, Moonkyung Joo, Jong-Jae Park
Diagnostics.2021; 11(11): 2123. CrossRef
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Focused Review Series: Updates on Capsule Endoscopy from Esophagus to Colon
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Recent Advance in Colon Capsule Endoscopy: What’s New?
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Sung Noh Hong, Sun-Hyung Kang, Hyun Joo Jang, Michael B. Wallace
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Clin Endosc 2018;51(4):334-343. Published online July 31, 2018
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DOI: https://doi.org/10.5946/ce.2018.121
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Abstract
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- Colon capsule endoscopy (CCE) is a relatively new diagnostic procedure for patients with suspected colonic diseases. This convenient,noninvasive method enables the physician to explore the entire colon without significant discomfort to the patient. However, while CCEcan be performed painlessly without bowel air insufflation, the need for vigorous bowel preparation and other technical limitationsexist. Due to such limitations, CCE has not replaced conventional colonoscopy. In this review, we discuss historical and recentadvances in CCE including technical issues, ideal bowel preparation, indications and contraindications and highlight further technicaladvancements and clinical studies which are needed to develop CCE as a potential diagnostic tool.
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Focused Review Series: Training in Endoscopy
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Training in Endoscopy: Colonoscopy
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Hyun Joo Jang
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Clin Endosc 2017;50(4):322-327. Published online July 31, 2017
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DOI: https://doi.org/10.5946/ce.2017.077
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Abstract
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- Colonoscopy is effective in reducing the morbidity and mortality associated with colorectal cancer (CRC). Interval cancers or post-colonoscopy CRCs, are cancers detected within the surveillance interval, or between 6–36 months after a clearing colonoscopy. The incidence of interval cancers is 3.4%–9.2% of all detected CRCs, as reported in population-based studies. Colonoscopy is a technically difficult procedure that is challenging to learn, and needs time and effort to gain competency. Therefore, trainee competence is a critical component of CRC screening and surveillance. Herein, we review the colonoscopy training methods and quality assessment metrics for colonoscopy competency.
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Review
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Quality Indicators for Small Bowel Capsule Endoscopy
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Ki-Nam Shim, Seong Ran Jeon, Hyun Joo Jang, Jinsu Kim, Yun Jeong Lim, Kyeong Ok Kim, Hyun Joo Song, Hyun Seok Lee, Jae Jun Park, Ji Hyun Kim, Jaeyoung Chun, Soo Jung Park, Dong-Hoon Yang, Yang Won Min, Bora Keum, Bo-In Lee, Korean Gut Image Study Group
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Clin Endosc 2017;50(2):148-160. Published online March 30, 2017
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DOI: https://doi.org/10.5946/ce.2017.030
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Abstract
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Supplementary Material
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- Capsule endoscopy (CE) enables evaluation of the entire mucosal surface of the small bowel (SB), which is one of the most important steps for evaluating obscure gastrointestinal bleeding. Although the diagnostic yield of SB CE depends on many clinical factors, there are no reports on quality indicators. Thus, the Korean Gut Image Study Group (KGISG) publishes an article titled, “Quality Indicators for Small Bowel Capsule Endoscopy” under approval from the Korean Society of Gastrointestinal Endoscopy (KSGE). Herein, we initially identified process quality indicators, while the structural and outcome indicators are reserved until sufficient clinical data are accumulated. We believe that outcomes of SB CE can be improved by trying to meet our proposed quality indicators.
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Case Report
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Giant Brunner's Gland Adenoma of the Proximal Jejunum Presenting as Iron Deficiency Anemia and Mimicking Intussusceptions
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Chan Soo So, Hyun Joo Jang, Yun Sun Choi, Dong Hee Koh, Min Ho Choi, Sea Hyub Kae, Sun Jung Min, Jin Lee
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Clin Endosc 2013;46(1):102-105. Published online January 31, 2013
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DOI: https://doi.org/10.5946/ce.2013.46.1.102
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Brunner's gland adenoma is a rare benign proliferative lesion developing most commonly in the posterior wall of the duodenum. It is usually small in size and asymptomatic. Depending on its size or location, however, the clinical manifestations of this tumor may be variable from nonspecific symptoms to gastrointestinal bleeding or obstruction. Brunner's gland adenoma in the proximal jejunum is extremely rare. We report a very rare case of giant Brunner's gland adenoma developing in the proximal jejunum which presented as iron deficiency anemia and mimicked intussusceptions on radiologic studies.
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