ABSTRACTS (pp 58–112)

Background: Gastrointestinal blood loss accounts for a significant part of chronic recurrent anemia. Conventional diagnostic work up includes esophagogastroduodenoscopy (EGD), colonoscopy and small bowel follow-through (SBF). Aim: To determine the diagnostic yield of CE in patients with chronic recurrent anemia without active gastrointestinal bleeding referred for CE in a tertiary center in Switzerland. Methods: CE is a minuscule color videocamera, light source, battery, transmitter and antenna all embedded in a swallowable capsule (M2A capsuleâ). Pictures are received through electrodes attached to the abdomen and stored on hard disk. Data are then transferred to a workstation and analysed (RAPID workstation). All pts referred to our institution for CE are enrolled in a prospective study evaluating acceptance, diagnostic yield and possible complications of the method. Pts referred for evaluation of chronic recurrent anemia were eligible. All patients had a normal SBF and no bleeding source detected in EGD and colonoscopy. Patients with known active bleeding were excluded. Other exclusion criteria were small bowel stenosis in SBF and patients with pacemakers or ICD. Results: 32 pts underwent CE from May 2002 until May 2003. Of those, 8 pts were referred for chronic anemia and included. There were 4 men (50%) and 4 women (50%). The mean age was 60 years (range 40– 78 years). The mean hemoglobin was 94 g/l (range 65–161 g/l), the mean MCV was 85 fl (range 76–93 fl). In 4 of these 8 pts pathologies were found in the small bowel accounting for the anemia. There were 2 pts with angiodysplasias, 1 pt with an ulcer in the ileum and 1 pt with multiple erosions in the distal small bowel. All of these lesions were deemed to be potential bleeding sources. The mean hemoglobin in those pts with bleeding sources detected by CE was 84 g/l compared to 105 g/l in those pts with normal CE. The diagnostic yield of CE in this group of pts with chronic recurrent anemia and a normal SBF was 50%. Conclusions: CE provides a meaningful diagnostic yield in patients with chronic recurrent anemia and normal EGD and colonoscopy and a normal SBF. The diagnostic yield seems to increase in pts with a lower hemoglobin.