Acta gastroenterologica Latinoamericana · 2026
[Diagnostic Agreement Between Capsule Endoscopy and Double-Balloon Enteroscopy in Mid-Gut Gastrointestinal Bleeding at a Referral Hospital in Peru].
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Castillo-Contreras Ofelia, Asencios-Cusihuallpa Jairo, Ayala-Quintanilla Elizabeth
Аннотация
INTRODUCTION: The diagnostic approach to mid-gut gastrointestinal bleeding requires several examinations, primarily video capsule endoscopy followed by double-balloon enteroscopy) at tertiary care centers.
OBJECTIVE: To evaluate the level of diagnostic agreement between video capsule endoscopy and double-balloon enteroscopy in patients treated with mid-gut gastrointestinal bleeding at a referral hospital in Lima, Peru, during the 2020-2025 period.
METHODS: This was an observational, retrospective, and comparative study. Diagnostic agreement between the two procedures was calculated using the Kappa coefficient. Statistical analysis was performed using IBM SPSS Statistics v.20.0 and R software version 4.1.2, with a significant p-value < 0.05.
RESULTS: In fifty-one patients with mid-gut gastrointestinal bleeding (28 women; median age: 65 years [IQR: 55-71]), video capsule endoscopy and subsequent double-balloon enteroscopy (39 antegrade and 12 retrograde) were performed. Most patients (34/51; 66.7%) presented with overt mid-gut gastrointestinal bleeding, while the rest had occult bleeding, with a mean hemoglobin level of 7.3 ± 2.24 g/dL. The median time interval between the two procedures was 13 days (IQR 5-29). In 10 (19.6%) patients where video capsule endoscopy showed positive findings, no lesions were identified during double-balloon enteroscopy , whereas in one case (2%) with a negative video capsule endoscopy , double-balloon enteroscopy was positive. Overall diagnostic agreement was low (κ = 0.37; [95% CI: 0.10-0.64]; p = 0.002). Moderate agreement was observed regarding lesion type (κ = 0.58; [95% CI: 0.42-0.74]; p < 0.001) and lesion location (κ = 0.50; [95% CI: 0.31-0.69]; p < 0.001), with moderate agreement for vascular (κ = 0.60) and tumoral (κ = 0.60) lesions.
CONCLUSION: Video capsule endoscopy and double-balloon enteroscopy showed low overall diagnostic agreement in patients with mid-gut gastrointestinal bleeding, and moderate agreement regarding the type and location of the lesion.
OBJECTIVE: To evaluate the level of diagnostic agreement between video capsule endoscopy and double-balloon enteroscopy in patients treated with mid-gut gastrointestinal bleeding at a referral hospital in Lima, Peru, during the 2020-2025 period.
METHODS: This was an observational, retrospective, and comparative study. Diagnostic agreement between the two procedures was calculated using the Kappa coefficient. Statistical analysis was performed using IBM SPSS Statistics v.20.0 and R software version 4.1.2, with a significant p-value < 0.05.
RESULTS: In fifty-one patients with mid-gut gastrointestinal bleeding (28 women; median age: 65 years [IQR: 55-71]), video capsule endoscopy and subsequent double-balloon enteroscopy (39 antegrade and 12 retrograde) were performed. Most patients (34/51; 66.7%) presented with overt mid-gut gastrointestinal bleeding, while the rest had occult bleeding, with a mean hemoglobin level of 7.3 ± 2.24 g/dL. The median time interval between the two procedures was 13 days (IQR 5-29). In 10 (19.6%) patients where video capsule endoscopy showed positive findings, no lesions were identified during double-balloon enteroscopy , whereas in one case (2%) with a negative video capsule endoscopy , double-balloon enteroscopy was positive. Overall diagnostic agreement was low (κ = 0.37; [95% CI: 0.10-0.64]; p = 0.002). Moderate agreement was observed regarding lesion type (κ = 0.58; [95% CI: 0.42-0.74]; p < 0.001) and lesion location (κ = 0.50; [95% CI: 0.31-0.69]; p < 0.001), with moderate agreement for vascular (κ = 0.60) and tumoral (κ = 0.60) lesions.
CONCLUSION: Video capsule endoscopy and double-balloon enteroscopy showed low overall diagnostic agreement in patients with mid-gut gastrointestinal bleeding, and moderate agreement regarding the type and location of the lesion.