by Suman Gupta
Pune, October, 2024: A 73-year-old male patient presented with malena, hypotension and weakness and was admitted to ICU at Manipal Hospital, Kharadi, Pune . He was presented at the hospital with severe symptoms, including continuous melena (black, tarry stools), weakness, lightheadedness, and low blood pressure. Despite no prior history of digestive issues, he had been experiencing a gradual loss of appetite and unexplained weight loss over the preceding months.
Upon admission, his routine blood tests revealed extremely low hemoglobin (Hb) level of 5.6 g/dL, indicating significant internal bleeding. After initial treatment, his hemoglobin level rose to 7.4 g/dL but soon dropped again to 6.6 g/dL, prompting further investigation to identify the cause of the bleeding.
The initial diagnostic approach included gastroscopy, which ruled out issues in the upper gastrointestinal tract, and colonoscopy, which revealed altered blood in the colon and terminal ileum but failed to diagnose the bleeding source. An abdominal CT angiography was performed to check for vascular abnormalities, but the results were inconclusive.
Looking at the patient’s condition, the team of doctors decided to use the advanced technique of capsule endoscopy, a non-invasive diagnostic tool that allows to visualize the entire small intestine, an area often difficult to assess with traditional methods. The patient ingested a small capsule containing a tiny camera, which captured images of the gastrointestinal tract as it passed through over a period of 12 to 14 hours. These images were transmitted to an external recorder worn by the patient.
Further describing the diagnostic procedure and treatment, Dr. Mangesh Borkar, Consultant – Gastroenterologist, Manipal Hospital, Kharadi, Pune said, “After the capsule completed its journey through the digestive system, the data was retrieved and thoroughly analyzed. We identified ulcers in the jejunum and ileum, which were responsible for the patient’s gastrointestinal bleeding. This precise diagnosis allowed us to develop a targeted treatment plan that significantly improved the patient’s prognosis. The patient responded well to the right course of treatment and was discharged within 5 days.”
Mr. Parameswar Das, Hospital Director, Manipal Hospital, Kharadi Said, “At Manipal Hospital Kharadi Pune, we are committed to adapt the latest advancements in medical technology to provide our patients with the most accurate diagnoses and effective treatments. The effective use of capsule endoscopy in this case shows not just our commitment to patient-centered care, but also our ongoing efforts to improve healthcare outcomes in our community.”
