Video capsule endoscopy in life-threatening G1 hemorrhage after negative primary endoscopy (with video)

Background: Video 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. Objective: Our purpose was to demonstrate the use of VCE as an early diagnostic tool in acute life-threatening GI hemorrhage. Design: Case series. Patients: Patients with life-threatening GI hemorrhage. Interventions: VCE after negative primary endoscopy. Results: VCE 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. Limitations: This 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. Conclusions: The 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.