At the DGE-BV (German Society of Endoscopy) Online Symposium on 7 October 2020, A. Schmidt., Freiburg, Germany, reported on data multicentric case series with the novel sensor capsule HemoPill acute for detection of bleeding in the esophagus, stomach and small intestine. In the trial, the HemoPill acute capsule was used at 12 clinical centres in 61 circulatory stable patients, primarily with Glasgow-Blatchford Bleeding Score of 10 (range 0 – 19). Indications were suspected acute upper GI bleeding (n=45) and acute small bowel bleeding (n=12); suspected rebleeding after successful endoscopic hemostasis was another reason for use (n=4). All cases with clinically relevant GI bleeding were detected by the HemoPill acute. In all patients without clinical and endoscopic bleeding signs, bleeding was excluded correctly by the sensor capsule.
In 72 % (18/23), users expressed that negative HemoPill finding had influenced the therapeutic decision making and the further clinical course. Based on the negative finding, it was decided to perform an elective endoscopy instead of an immediate endoscopy (n=10), to avoid enteroscopy (n=5) or gastroscopy (n=3). There were no problems swallowing the capsule. No capsule retention and no complications occurred (0/61).
Within this case series, T. Brunk et al. Berlin, Germany, found that HemoPill acute detected active bleeding in the small intestine reliably in 13 patients with suspected acute GI bleeding and negative gastroscopy (Glasgow-Blatchford Bleeding Score of 6 – 10 (M 10, SD 2)). In all positive cases (7/7), double balloon enteroscopy was performed within 24 h, which showed angiodysplasia. All bleeding sites were successfully treated endoscopically. The use of the capsule was complication-free in all.
According to the results of the multicentre data collection, HemoPill acute was shown to be effective in emergency diagnostics. In addition, the authors concluded that HemoPill acute may become an inexpensive non-endoscopic tool for the detection of active bleeding in the small intestine.