Video capsule endoscopy in life-threatening GI hemorrhage after negative primary endoscopy (with video)

BackgroundVideo capsule endoscopy (VCE) continues to evolve as a key diagnostic tool. Traditionally VCE has been used to detect occult and obscure GI bleeding in adult patients. VCE has not been documented or accepted as an early diagnostic tool for acute life-threatening GI hemorrhage.ObjectiveOur purpose was to demonstrate the use of VCE as an early diagnostic tool in acute life-threatening GI hemorrhage.DesignCase series.PatientsPatients with life-threatening GI hemorrhage.InterventionsVCE after negative primary endoscopy.ResultsVCE allowed rapid diagnosis and reliable data before surgical intervention. Although proving to be a beneficial diagnostic tool for acute GI hemorrhage, VCE was not associated with increased morbidity or mortality rates.LimitationsThis report only focuses on cases where VCE successfully led to a diagnosis. There is no prospective control group to which these patients can be compared. There were no other attempted acute VCE studies in patients with life-threatening bleeding during the time period of these case reports.ConclusionsThe use of VCE is a simple and relatively safe diagnostic tool in the evaluation of continuing GI hemorrhaging in endoscopy-negative patients. The use of VCE can be considered as a another useful tool in the armamentarium of the endoscopist in the evaluation of GI bleeding. Prospective studies should be undertaken to determine the appropriate timing and clinical use in this group of patients.