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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