Capability of Capsule Endoscopy in Detecting Small Bowel Ulcers

Ersoy, Osman; Harmanci, Æ Ozgur; Aydınlı, Musa; Sıvrı, Bülent; Bayraktar, Yusuf

doi:10.1007/s10620-008-0320-0

Cited by 18 publications

(9 citation statements)

References 34 publications

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“…In differential diagnosis of CMUSE, first of all Crohn's disease (9,15), NSAIDs-induced enteropathy (9,35), tuberculosis and other infections of the small bowel (8,9,20), Behcet disease (19,21,24) and malignancies must be excluded. It is a well-known fact, that the majority of extranodal malignant lymphoma involves the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

Severe Cryptogenic Multifocal Ulcerous Stenosing Enteritis. A Report of Three Cases and Review of the Literature

Kohoutová

Bureš

Tyčová

et al. 2010

Acta Med. (Hradec Kralove, Czech Repub.)

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IntroductionCryptogenic multifocal ulcerous stenosing enteritis (CMUSE) is a rare condition characterised by chronic or relapsing moderate ileous episodes resulting from multiple small intestinal strictures, multiple shallow ulcers of the small bowel and beneficial therapeutical effect of glucocorticosteroids (1, 2). Japanese gastroenterologists call this syndrome chronic non-specific multiple ulcers of the small intestine (CNSU) (3). The aetiology of CMUSE has not been clarified yet and pathogenesis is still poorly understood. Some authors even doubt the real existence of this entity.Patients with CMUSE are often referred for surgery because of symptomatic small intestinal strictures and several resections of the small bowel had to be performed.We report three cases of CMUSE diagnosed within the past 10 years at a single tertiary centre, where more than eight thousand GI endoscopies are performed per year. Review of available relevant literature is provided. Case reports Case 1A 35-year-old woman was admitted to our department because of chronic diarrhoea, colicky abdominal pain, weight loss (16 kg during previous five years) and repeated moderate ileous episodes. She was cachectic (body-mass index 12.8 kg/m 2 ). Laboratory tests showed iron-deficiency anaemia (haemoglobin 96 g/L), thrombocytosis (459.10 9 g/L) and proteino-energy malnutrition (serum prealbumin 0.17 g/L). Abdominal ultrasound revealed strenuous small intestinal peristalsis and a large volume of fluid in the intestinal loops. Enteroclysis provided no further information. Gastroscopy and colonoscopy were normal. Push-enteroscopy found multiple shallow ulcers of the distal duodenum and proximal jejunum ( Fig. 1) and increased stagnant fluid content in the proximal part of the small bowel. A non-specific inflammatory process was detected at histology and electron microscopy of small intestinal biopsy specimens. Coeliac disease, lymphoma, Crohn's disease and vasculitis were excluded. No infective agent was found. Total parenteral nutrition and glucocorticosteroids improved her general condition including nutritional status (serum albumin 35.8 g/L, prealbumin 0.29 g/L, body-mass index 13.4 kg/m 2 ). The patient was discharged on enteral nutrition, glucocorticosteroids (prednisone was gradually replaced by budesonide) and 5-aminosalicylates. She was followed-up at regular controls. Nine months later the patient had to be admitted because of a worsened general condition (frequent watery stools, fatigue, oedemas of lower extremities, fluidothorax and ascites). Laboratory tests revealed hypo-25 CASE REPORT Summary: Cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) is a rare condition characterised by chronic or relapsing moderate ileous episodes resulting from multiple small intestinal strictures, multiple shallow ulcers of the small bowel and favourable therapeutical effect of glucocorticosteroids. The aim of this paper was to evaluate three cases of CMUSE diagnosed within 10 years at a tertiary gastroenterology centre. Three females (35, 50, ...

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Section: Discussionmentioning

confidence: 99%

Severe Cryptogenic Multifocal Ulcerous Stenosing Enteritis. A Report of Three Cases and Review of the Literature

Kohoutová

Bureš

Tyčová

et al. 2010

Acta Med. (Hradec Kralove, Czech Repub.)

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“…If patients with other signs and symptoms of inflammation were selected, than the diagnostic yield was considerably higher [62] . Capsule endoscopy may be helpful in the diagnosis of the following diseases: surveillance for NSAID side effects, Henoch-Schönlein purpura, indeterminate colitis, protein losing enteropathy, intestinal lymphangiectasia, Meckel's diverticulum, follow-up of SB transplantation, GVHD, and bowel changes in refractory pouchitis [1][2][3][4][5][6][7][8][9][10]62] .…”

Section: Other Indicationsmentioning

confidence: 99%

“…Recent studies showed the superiority of CE over conventional methods, but passive features such as inability to insufflate the bowel and to biopsy and lack of therapeutic capability have generated a debate on its advantages [6][7][8][9][10][11][12][13][14] . Newly developed balloon assisted enteroscopes are also available and have the potential to outscore CE in terms of diagnostic indications and therapeutic applications.…”

Section: Introductionmentioning

confidence: 99%

Five years’ experience with capsule endoscopy in a single center

Kav¹,

Bayraktar²

2009

WJG

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Capsule endoscopy (CE) is a novel technology that facilitates highly effective and noninvasive imaging of the small bowel. Although its efficacy in the evaluation of obscure gastrointestinal bleeding (OGIB) has been proven in several trials, data on uses of CE in different small bowel diseases are rapidly accumulating in the literature, and it has been found to be superior to alternative diagnostic tools in a range of such diseases. Based on literature evidence, CE is recommended as a first-line investigation for OGIB after negative bidirectional endoscopy. CE has gained an important role in the diagnosis and follow-up of Crohn's disease and celiac disease and in the surveillance of small bowel tumors and polyps in selected patients. Capsule retention is the major complication, with a frequency of 1%-2%. The purpose of this review was to discuss the procedure, indications, contraindications and adverse effects associated with CE. We also review and share our five-year experience with CE in various small bowel diseases. The recently developed balloon-assisted enteroscopies have both diagnostic and therapeutic capability. At the present time, CE and balloon-assisted enteroscopies are complementary techniques in the diagnosis and management of small bowel diseases.

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“…It has been reported that VCE is superior to enteroscopy, small-bowel follow-through, and enteroclysis in identifying the source of small-intestinal bleeding and other pathologies with the diagnostic yield of 45-80% [1][2][3][4][5][6][7][8]. The difference in the rate of positive findings between VCE and conventional modalities including push enteroscopy, small-bowel follow-through or enteroclysis, or colonoscopy with ileoscopy for small-bowel disease was 74 and 41% in two previous meta-analyses [9,10].…”

Section: Introductionmentioning

confidence: 98%