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Urgent Panendoscopy in Patients Presenting With Hematochezia
Sponsor: Mahidol University
Summary
Gastrointestinal bleeding is a significant emergency condition requiring prompt diagnosis. Current evidence presents a clinical paradox: urgent colonoscopy (within 24 hours) shows no clear benefit in several studies, while urgent video capsule endoscopy (VCE) demonstrates improved detection rates for small bowel bleeding. This study aims to evaluate a novel approach combining urgent colonoscopy followed by same-day VCE for patients with normal colonoscopy findings. This strategy has not been previously assessed and may improve bleeding source detection while reducing patient preparation burden compared to standard sequential testing. Results will be compared against conventional approaches to determine optimal diagnostic timing for patients presenting with hematochezia
Official title: Diagnostic Yield of Urgent Panendoscopy VS. Conventional Endoscopic Evaluation in Patients Presenting With Hematochezia : Randomized Controlled Trial
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
188
Start Date
2024-04-09
Completion Date
2028-01
Last Updated
2025-05-30
Healthy Volunteers
No
Interventions
Urgent endoscopy strategy
Patients will undergo colonoscopy within 24 hours of diagnosed lower gastrointestinal bleeding. If no bleeding source is identified on colonoscopy or presumed diverticular bleeding cases, esophagogastroduodenoscopy (EGD) followed by same-session video capsule endoscopy (VCE) will be performed immediately
Standard colonoscopy with standard VCE group
Patients will undergo colonoscopy within 24-48 hours after diagnosed lower gastrointestinal bleeding. If no bleeding source is identified on colonoscopy or presumed diverticular bleeding cases, esophagogastroduodenoscopy (EGD) will be performed immediately. If EGD shows no bleeding source, video capsule endoscopy (VCE) will be performed within 24 hours of the preceding endoscopies
Locations (1)
Gastroenterology division, Faculty of Medicine, Siriraj Hospital, Mahidol University Bangkok, , Thailand
Bangkok, Bangkok, Thailand