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KMID : 0988920110090020129
Intestinal Research
2011 Volume.9 No. 2 p.129 ~ p.138
Capsule Endoscopy for Suspected Small Bowel Bleeding in Patients with Portal Hypertension
Cheon Kang-Il

Kim Jin-Oh
Hong Sung-Wook
Jeon Seong-Ran
Lee Tae-Hee
Kim Hyun-Gun
Cho Won-Young
Kim Wan-Jung
Kim Min-Jeong
Jung Seung-Won
Jang Jae-Young
Ko Bong-Min
Cho Joo-Young
Lee Joon-Seong
Abstract
Background/Aims :In Korea, limited data are available on small bowel bleeding in patients with portal hypertension. This study reports on the use of capsule endoscopy in cases of suspected small bowel bleeding in patients with portal hypertension.

Methods:Capsule endoscopy was used at our hospital to evaluate small bowel disease in 501 cases from July 2003 to June 2010. Of those cases, nine patients with portal hypertension due to liver cirrhosis with suspected small bowel bleeding were selected for the study. A retrospective analysis was performed using data from medical records.

Results:Six of the nine (66.7%) patients were males with an average age of 53.4 years. The average hemoglobin level was 8.1 g/dL. Abnormalities noted during capsule endoscopy included portal hypertensive enteropathy in all nine cases (100%), jejunal varices in four (44.4%), jejunal and ileal angiodysplasia in five (55.5%), multiple small bowel erosions in one (11.1%), granularity of the jejunal mucosa in one (11.1%), and small bowel erythema in three (33.3%). Active bleeding from jejunal varices was detected in two patients (22.2%). Despite having no obvious active bleeding during the capsule endoscopy, four patients (44.4%) were diagnosed with portal hypertensive enteropathy with obscure small bowel bleeding.

Conclusions:Capsule endoscopy is a useful diagnostic tool for the evaluation of small bowel bleeding in patients with portal hypertensive enteropathy. Additional prospective and multicenter studies on the use of capsule endoscopy are needed to evaluate the incidence and clinical importance of portal hypertensive enteropathy.
KEYWORD
Capsule Endoscopy, Liver Cirrhosis, Small Bowel Bleeding, Portal Hypertensive Enteropathy
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