PillCam Picks Up Internal Bleeding in ER

A camera in a pill, given in the emergency room, is a sensitive way to detect upper gastrointestinal (GI) bleeding, researchers reported.

In a pilot 25-patient study, the camera – about the size of a large vitamin pill – was both accurate and well tolerated by patients who were suspected of having acute upper GI hemorrhage, according to Andrew Meltzer, MD, of George Washington University in Washington, D.C., and colleagues.

There was also "excellent" agreement between gastroenterologists and ER physicians on the interpretation of images from the camera, Meltzer and colleagues reported online in Annals of Emergency Medicine.

The device has a camera at both ends and, once swallowed, transmits real-time images to a data recorder, which can be viewed at the bedside and saved for later review. The camera itself is later excreted and not recovered.

The gold standard for risk stratification in such cases is an esophagoduodenoscopy, which is invasive and – since gastroenterologists usually perform it after hospital admission – costly.

When esophagoduodenoscopy is performed in the emergency setting, Meltzer and colleagues noted, between 30% and 46% of patients can be safely discharged, avoiding the expense of a hospital stay.

However, since gastroenterologists are frequently not available in the emergency room, many patients are admitted, only to have negative results on esophagoduodenoscopy.

The pill camera – more formally, "video capsule endoscopy" -- might be a way to overcome that logistical roadblock, the researchers hypothesized.


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