Abstract
Background and study aims Video capsule endoscopy (VCE) is a minimally invasive tool that helps visualize the
gastrointestinal tract from the esophagus to the right colon without the need for
sedation or preparation. VCE is safe with very few contraindications. However, its
role and safety profile in the intensive care unit (ICU) population have not been
reported. The aim of this study is to evaluate the safety, efficacy, and feasibility
of VCE use in ICU patients.
Patients and methods We conducted a single-center retrospective observational study of patients who underwent
VCE for evaluation of obscure overt gastrointestinal bleeding in the ICU between 2008
and 2016.
Results This study included 48 patients who were admitted to the UMass Memorial Medical Center
ICUs for gastrointestinal bleeding. VCE was successfully completed in 43/48 (90 %)
patients. The entire length of small bowel could be evaluated in 75 % and the source
of bleeding was identified in 44 % of the patients. The most commonly identified source
of bleeding included small bowel angioectasias, duodenal erosions/ulcers, and small
bowel polyps. No major complications could be attributed to the VCE. Only 1 capsule
was retained after 2 wk; however, there was no incidence of bowel obstruction, perforation,
or capsule aspiration.
Conclusions This observational retrospective study demonstrates that VCE may be a safe, feasible,
and effective diagnostic tool in evaluation of gastrointestinal bleeding in the ICU
population with few complications. VCE may be a safe diagnostic prelude and be a guide
to the correct therapeutic procedure if needed, in the context of patients who are
seriously ill.
