P4115 - Are Red Spots Linked to GI Bleeding? A Retrospective Chart Review

Salil Chowdhury, MD, Maria F. Winte, MD, Tina Boortalary, MD, Christina Tofani, MD
Thomas Jefferson University Hospital, Philadelphia, PA

Introduction: Red spot is a consensus term representing a small bowel mucosal lesion (measuring less than 1 mm). They are frequently seen on small bowel capsule endoscopy (SBCE), a non-invasive and commonly used diagnostic modality to evaluate anemia and gastrointestinal bleeding. Much remains uncertain about red spots regarding their frequency and hemorrhagic potential.

Methods: The PillCam Web Software was reviewed to identify patients who underwent small bowel capsule endoscopy at our tertiary medical center from 1/1/2019 - 12/31/2020. Patients who had a finding of “red spots” were further investigated with chart review. Those who had incomplete data were excluded. Demographic information, further endoscopic procedures, readmission rates, and need for transfusion was assessed. Fisher's exact test was used to evaluate readmission rates in those with red spots and AVMs, history of chronic kidney disease (CKD), and history of blood thinner use.

Results: A total of 52 patients were identified with red spots on SBCE (7.6%). 7 patients were excluded due to inability to locate a patient chart or incomplete data. Of the 45 patients who underwent further chart review, 12 were noted to also have AVMs in addition to red spots. Of the 45 patients, 8.8% had blood on their capsule study. About half of the patients found to have red spots on SBCE required blood transfusions and further endoscopic management (48.8% and 46.7%, respectively). 6 patients were readmitted to the hospital for anemia or gastrointestinal bleeding. There was no difference in readmissions in those who had red spots with or without AVMs (p=0.319), history of CKD (0.0687), or use of blood thinners (antiplatelets and anticoagulation) (p=0.399).

Discussion: Much remains unknown about red spots, often seen on SBCE. Since the most common indication for SBCE is GI bleeding, it is unsurprising that blood transfusions, additional endoscopies, and hemostasis with clips and/or argon plasma coagulation is often required to treat patients found to have red spots. Further research is necessary to understand the risk and character of this endoscopic finding.



Disclosures:


Salil Chowdhury, MD, Maria F. Winte, MD, Tina Boortalary, MD, Christina Tofani, MD. P4115 - Are Red Spots Linked to GI Bleeding? A Retrospective Chart Review, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.