Video Capsule Endoscopy for Detection of Gastrointestinal Bleeding in the Small Bowel

Study Overview
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Brief Summary
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Small bowel capsule endoscopy is the main diagnostic standard for small bowel bleeding. This study investigates the detection rate of small bowel bleeding in capsule endoscopy and further endoscopic treatment in a prospective and retrospective cohort.

Detailed Description
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Small bowel capsule endoscopy is considered the diagnostic gold standard in the diagnosis of diseases of the small bowel. Most indications for capsule endoscopy are overt small bowel bleedings - defined as gastrointestinal bleeding after negative gastroscopy and colonoscopy - or occult iron deficiency anemia. Timing of small bowel capsule endoscopy seems to be decisive for the diagnosis of small bowel bleeding: corresponding to the actual guidelines the detection of small bowel bleeding can be up to > 70% if the intervention is performed within 2 days. Treatment of small bowel bleedings can be performed with small bowel enteroscopy such as balloon or motorized spiral enteroscopy. Against this background this study investigates the rate of small bowel bleeding diagnosed in capsule endoscopy. The aim of the study is to report tumorous, vascular and inflammatory findings as well as complications and cecal accessibility. One focus of the study is the time between small bowel bleeding and small bowel capsule endoscopy and small bowel enteroscopy, respectively. Endoscopic therapies and further bleeding episodes are recorded. In order to determine the improved clinical outcome after the introduction of the shortened timing for recommendation published in 2022, a retrospective cohort should be included in addition to a prospective cohort.

Official Title
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Video Capsule Endoscopy for Detection of Gastrointestinal Bleeding in the Jejunum

Conditions
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GastroIntestinal Bleeding

Intervention / Treatment
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* Device: Small bowel capsule endoscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: suspicion of gastrointestinal bleeding in the small bowel undetected by gastroscopy and colonoscopy informed consent Exclusion Criteria: contraindications for small bowel capsule endoscopy (e.g. stenosis)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with gastrointestinal bleeding undetected in gastroscopy and colonoscopy<br>Gastrointestinal bleeding in the small bowel. | Device: Small bowel capsule endoscopy<br>* Patients with gastrointestinal bleeding receive small bowel capsule endoscopy after bleeding could not be located in gastroscopy or colonoscopy.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of small bowel bleeding detected during small bowel capsule endoscopy | Detection of bleeding during small bowel capsule endoscopy | Through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of vascular lesions as source of bleeding | Detection of vascular lesions angiodysplasia) as source of bleeding | Through study completion, an average of 1 year | 
| Prevalence of inflammatory lesions as source of bleeding | Detection of inflammatory lesions as source of bleeding | Through study completion, an average of 1 year | 
| Prevalence of tumor lesions as source of bleeding | Detection of tumor lesions as source of bleeding | Through study completion, an average of 1 year | 
| Complications of small bowel capsule endoscopy | Complications of small bowel capsule endoscopy | Through study completion, an average of 1 year | 
| Technical success of small bowel capsule endoscopy | Technical success is defined as arrival of the capsule in the cecum | Through study completion, an average of 1 year | 
| Time between diagnostic small bowel capsule endoscopy and small bowel enteroscopy for treatment of bleeding | Time between diagnostic mall bowel capsule endoscopy and small bowel enteroscopy for treatment of bleeding | From time to the end of capsule endoscopy until beginning of small bowel enteroscopy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Small bowel capsule endoscopy, gastrointestinal bleeding, anticaogulation