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February 19, 1973

"Duodenal Capsule" for Localization of Upper Gastrointestinal Bleeding

Author Affiliations

Palo Alto, Calif

JAMA. 1973;223(8):924. doi:10.1001/jama.1973.03220080054027

To the Editor.—  Occasionally patients with acute gastrointestinal hemorrhage are too ill or uncooperative for diagnostic procedures such as endoscopy, barium x-ray studies, or selective abdominal arteriography. Bleeding mucosal lesions will show blood on a swallowed string at approximately 35 to 40 cm if in the esophagus, at 40 to 55 cm in the stomach, and at 55 to 75 in the proximal duodenum. Various string tests for localization of gastrointestinal hemorrhage have been the subject of several previous articles.1-3Our experience with more than 60 patients using umbilical tape and either a small lead ball2 or mercury filled finger cot3 as the weighted end has shown 40% unable to swallow the string or to keep it down. Switz and North4 reported 7 of 22 nonbleeding subjects could not swallow a 0.63-cm braided tape. They also found that 12 of the 15 subjects had blood on