LAUSR

Introduction Literature comparing axial small bowel capsule endoscopy (SBCE) (Pillcam, Given Imaging) and panoramic SBCE (Capsocam, Capsovision) in obscure gastrointestinal bleeding (OGIB) is limited and contradictory [1,2]. Methods Consecutive patients who presented with overt OGIB at a tertiary centre over a 5 year period underwent either Capsocam SBCE or Pillcam SB3 SBCE. All had negative gastroscopies and colonoscopies/CT colonographies. SBCEs were reviewed by 2 experts. Findings in the 2 groups were compared. Results 94 patients (39.4% Capsocam; 60.6% Pillcam; 57.4% males; mean age 64.3±18.0 years) were included. Both groups were age (p=0.174) and gender (p=0.137) matched. Severity of anaemia (p=0.053) and duration of anaemia (p=0.264) were similar in both groups. There was no difference between groups in incomplete SBCEs (p=0.151). Diagnostic yield (DY) was comparable in both groups but Pillcam had a higher DY than Capsocam in the stomach (table 1). Abstract PWE-025 Table 1: DY of panoramic and axial SBCE for patients with overt OGIB; Capsocam n(%) Pillcam n(%) Significance (p) Gastric DY 3 (8.1) 15 (26.3) 0.033 Small bowel (SB) DY 17 (45.9) 25 (43.9) 0.842 Colon DY 2 (5.4) 3 (5.3) 0.976 Capsocam identified blood (2, 5.4%), erosions (1, 2.7%) and ulcers (1, 2.7%) in the stomach. Pillcam showed blood (4, 5.4%), erosions (11, 19.3%), ulcers (2, 3.5%), varices (1, 1.8%) and GAVE (1, 1.8%) in the stomach. Patients who underwent Capsocam examination had the following findings in the SB: 1 (2.7%) ulcer, 7 (18.9%) angioectasia, 8 (21.6%) blood, 2 (5.4%) erosions, 1 (2.7%) tumour, 1 (2.7%) diverticulum. Patients who underwent Pillcam had these findings in the SB – 10 (17.5%) ulcers, 11 (19.2%) angioectasia, 7 (12.3%) blood, 19 (33.3%) erosions, 1 (1.75%) tumour, 2 (3.51%) diverticulum, 2 (3.51%) phlebactesia, 4 (7.02%) polyps, 1 (1.75%) haemangioma, 1 (1.75%) intussusception. Conclusions SB DY was comparable between Capsocam and Pillcam groups in patients with overt OGIB but Pillcam offered a better gastric DY than Capsocam. This might be of relevance as a considerable number of lesions are missed in the upper GI tract in patients undergoing gastroscopy. References Pioche M, Vanbiervliet G, Jacob P, Duburque C, Gincul R, Filoche B, Daudet J, Filippi J, Saurin JC, (SFED) FSoDE: Prospective randomized comparison between axial- and lateral-viewing capsule endoscopy systems in patients with obscure digestive bleeding. Endoscopy 2014, 46:479–484. Zwinger LL, Siegmund B, Stroux A, Adler A, Veltzke-Schlieker W, Wentrup R, Jürgensen C, Wiedenmann B, Wiedbrauck F, Hollerbach S, et al.: CapsoCam SV-1 Versus PillCam SB 3 in the Detection of Obscure Gastrointestinal Bleeding: Results of a Prospective Randomized Comparative Multicenter Study. J Clin Gastroenterol 2018.