Capsule endoscopy in obscure gastrointestinal bleeding.

Wireless capsule endoscopy is being used increasingly in the investigation of obscure gastrointestinal (GI) bleeding. Capsule endoscopy can establish a diagnosis in a high proportion of patients with obscure GI bleeding, detecting small bowel lesions but also, on occasion, detecting lesions outside the small bowel. Capsule endoscopy seems to be useful in selecting patients with obscure GI bleeding for intra-operative enteroscopy for optimal management and outcomes. There is growing recognition that many bleeding lesions diagnosed by capsule endoscopy are within the reach of routine endoscopy. Capsule endoscopy has been proposed as a replacement for push enteroscopy in the investigation of obscure GI bleeding after negative initial endoscopy. The authors recommend that patients with obscure GI bleeding should have a second look or "second opinion" endoscopy.

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