Researchers examined the ability of emergency physicians to detect blood in the upper gastrointestinal tract using video capsule endoscopy in the ED. The researchers studied 25 patients with acute upper gastrointestinal hemorrhage at an academic hospital over six months.
Two emergency physicians who received brief training in capsule endoscopy interpretation and two gastroenterologists with capsule endoscopy experience examined video images of the patients. The overall agreement between the gastroenterologists and emergency physicians for the presence of fresh or coffee-ground blood was very strong at 0.96, according to the study. In addition, capsule endoscopy was well tolerated by 96 percent of patients and had 88 percent sensitivity and 64 percent specificity for the detection of fresh blood.
The authors wrote, “Although expensive, video capsule endoscopy may be cost-effective if it safely reduces hospital admissions or emergency esophagoduodenoscopies.”
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