Long-term effects of video capsule endoscopy in the management of obscure gastrointestinal bleeding

Tziatzios, Georgios; Gkolfakis, Paraskevas; Dimitriadis, George; Triantafyllou, Konstantinos

doi:10.21037/atm.2017.03.80

Cited by 17 publications

(10 citation statements)

References 64 publications

(121 reference statements)

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“…The scope of this capsule endoscopy technique therefore matched that of EGD, making DS-MCE a potential alternative to EGD especially for patients with contraindications to EGD or for those who refuse to undergo the procedure. In addition, the expanded range, from the esophagus to the small bowel, might make sense in some clinical situations, such as in the evaluation of gastrointestinal bleeding [11], recurrent or refractory iron deficiency anemia [12], and esophageal and gastric varices. Moreover, DS-MCE is safe for patients with dysphagia, as our previous study demonstrated the feasibility of pulling the capsule out if necessary [4].…”

Section: Discussionmentioning

confidence: 99%

Detachable string magnetically controlled capsule endoscopy for complete viewing of the esophagus and stomach

et al. 2019

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Background Esophageal capsule endoscopy is reported to be insufficiently accurate to replace esophagogastroduodenoscopy (EGD) because the passage of the capsule through the esophagus is passive and precludes a thorough investigation. We developed a modified capsule endoscopy technique, called detachable string magnetically controlled capsule endoscopy (DS-MCE), and performed a pilot study to assess the feasibility and safety of this novel technique. Methods 4 healthy volunteers and 21 patients with suspected esophageal disease first underwent DS-MCE followed by EGD within 1 week. Outcomes included technical success of DS-MCE, adverse events, discomfort, and diagnostic accuracy. Results DS-MCE was successfully carried out in all 25 participants. No adverse events were observed. Mean overall discomfort score during DS-MCE was 0.96 (range 0 – 3). DS-MCE diagnoses were in accordance with EGD in all 25 participants. The per-patient sensitivity of DS-MCE for esophageal disease detection was 100 %. The accuracy of DS-MCE for grading esophageal varices and reflux esophagitis were 66.7 % and 100 %, respectively. Conclusions DS-MCE was a feasible, safe, and well-tolerated method for viewing the esophagus and proceeding with gastric examination after string detachment.

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Section: Discussionmentioning

confidence: 99%

Detachable string magnetically controlled capsule endoscopy for complete viewing of the esophagus and stomach

et al. 2019

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“…Overall, CE can be used as a first-line investigation for small bowel ADs because of its usefulness in evaluating the localization, size and number of ADs, providing information on the best insertion route for DE. Since the re-bleeding rate was reportedly high in patients with positive VCE[35], subsequent interventional DE should be conducted even if the overt bleeding is temporarily relieved. On the other hand, there are no clear guidelines for patients with negative findings after an initial VCE examination.…”

Section: Diagnosismentioning

confidence: 99%

“…Since multiple lesions are reportedly identified in up to 63% of patients[25], observation of the entire small bowel is desirable to determine a suitable insertion route for subsequent DE. For patients with positive VCE, endoscopic intervention is usually conducted to treat target lesions, considering the higher rate of re-bleeding after a positive VCE result[35]. Meanwhile, watchful observation can be applied to patients with a negative VCE result.…”

Section: Diagnostic and Managemnet Strategies For Each Type Of Small mentioning

confidence: 99%

Diagnosis and therapeutic strategies for small bowel vascular lesions

Shimizu

Ohata

Nakajima

et al. 2019

WJG

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Small bowel vascular lesions, including angioectasia (AE), Dieulafoy’s lesion (DL) and arteriovenous malformation (AVM), are the most common causes of obscure gastrointestinal bleeding. Since AE are considered to be venous lesions, they usually manifest as a chronic, well-compensated condition. Subsequent to video capsule endoscopy, deep enteroscopy can be applied to control active bleeding or to improve anemia necessitating blood transfusion. Despite the initial treatment efficacy of argon plasma coagulation (APC), many patients experience re-bleeding, probably because of recurrent or missed AEs. Pharmacological treatments can be considered for patients who have not responded well to other types of treatment or in whom endoscopy is contraindicated. Meanwhile, a conservative approach with iron supplementation remains an option for patients with mild anemia. DL and AVM are considered to be arterial lesions; therefore, these lesions frequently cause acute life-threatening hemorrhage. Mechanical hemostasis using endoclips is recommended to treat DLs, considering the high re-bleeding rate after primary APC cauterization. Meanwhile, most small bowel AVMs are large and susceptible to re-bleeding therefore, they usually require surgical resection. To achieve optimal diagnostic and therapeutic approaches for each type of small bowel lesion, the differences in their epidemiology, pathology and clinical presentation must be understood.

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“… 13 Capsule endoscopy (CE) is currently available as a minimally invasive imaging procedure which contributes significantly to the identification of small bowel abnormalities. 14–16 CE revolutionised the evaluation for patients with obscure gastrointestinal bleeding because it allows reliable and non-invasive visibility of the mucosal surface in small bowels. Since 2001, CE has evolved into helpful diagnostic technology integrated in daily clinical practice.…”

Section: Introductionmentioning

confidence: 99%

“…Since 2001, CE has evolved into helpful diagnostic technology integrated in daily clinical practice. 14–16 On the other hand, with the progression of LC, the peristaltic movement of the gastrointestinal tract is expected to decrease due to PHG, which may lead to the delay in excretion of capsule endoscopy. 5 17–19 Small bowel capsule endoscopy (SBCE) has been utilised to characterise PHG and is valuable for the diagnosis of this condition in patients with LC who continue to bleed despite endoscopic treatment for EVs.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of capsule endoscopy in patients with cirrhosis for the diagnosis of upper gastrointestinal lesions and small bowel abnormalities: a study protocol for prospective interventional study

Iwata

Nishikawa

Enomoto

et al. 2017

BMJ Open Gastroenterol

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Introduction and aimsThe role of capsule endoscopy (CE) in patients with liver cirrhosis (LC) has yet to be established; however, it is likely that it will remain a valuable diagnostic modality in several groups of patients with LC. The primary aims of the current prospective interventional study are to examine the prevalence for small bowel lesions and transit time of CE in the gastrointestinal tract in patients with LC with oesophageal varices (EVs) requiring endoscopic therapies.Methods and analysisThe current study will be a single-centre prospective interventional study. Our study participants are LC subjects with portal hypertension who were determined to be necessary for prophylactic endoscopic therapies for EVs. From the view point of safety, patients with gastrointestinal obstruction or fistula or those being suspected of having gastrointestinal obstruction or fistula will be excluded from our study. Patients with implanted medical devices will be also excluded. CE will be performed prior to prophylactic endoscopic therapies in the same hospitalisation and relevant images will be analysed after 8 hours by expert endoscopists. This study will continue to recruit until 50 participants.Ethics and disseminationThis study has received approval from the Institutional Review Board at Hyogo College of Medicine (approval no. 2680). The study protocol, informed assent form and other submitted files were reviewed and acknowledged. Final data will be publicly scattered regardless of the study results. A report releasing study results will be submitted for publication in a suitable journal after being finished in data collection.Trial registration numberUMIN000028433 (https://upload.umin.ac.jp/).

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Long-term effects of video capsule endoscopy in the management of obscure gastrointestinal bleeding

Cited by 17 publications

References 64 publications

Detachable string magnetically controlled capsule endoscopy for complete viewing of the esophagus and stomach

Detachable string magnetically controlled capsule endoscopy for complete viewing of the esophagus and stomach

Diagnosis and therapeutic strategies for small bowel vascular lesions

Efficacy of capsule endoscopy in patients with cirrhosis for the diagnosis of upper gastrointestinal lesions and small bowel abnormalities: a study protocol for prospective interventional study

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