Non-small-bowel lesions identification by capsule endoscopy: A single centre retrospective study

Innocenti, Tommaso; Dragoni, Gabriele; Roselli, Jenny; Macrì, Giuseppe; Mello, Tommaso; Milani, Stefano; Galli, Andrea

doi:10.1016/j.clinre.2020.03.011

Cited by 11 publications

(15 citation statements)

References 35 publications

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“…In keeping with previous reports [27][28], our study corroborates the high diagnostic yield and safety of CE in the examination of the GI tract. CE demonstrated a diagnostic yield of 80% in our study population and identi ed clinically signi cant NSBLs not seen by conventional endoscopy in 16% of cases.…”

Section: Discussionsupporting

confidence: 92%

“…As upper and lower GI lesions are typically detectable using traditional endoscopy, in some cases an endoscopic second look may be warranted before proceeding with CE. Previous studies have reported the diagnostic yield of a second look as 35-75% for the upper GI tract and 6% for the lower GI tract [5,[26][27][28]. Although there is currently a lack of a strong recommendation, we believe that the high percentage of NSBLs suggests that a second look endoscopy is of value in patients with unreliable rst level exams, particularly in patients with persistent bleeding.…”

Section: Discussionmentioning

confidence: 86%

“…Several studies have reported the ability of CE to detect lesions missed on upper and lower GI endoscopy. [5,[22][23][24][26][27][28]. It is unclear why these lesions are missed during initial conventional endoscopy, although possible explanations have been hypothesized.…”

Section: Discussionmentioning

confidence: 99%

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Capsule Endoscopy in the Detection of Non-Small Bowel Lesions Missed by Endoscopy

Calabrese

Gelli

Dussias

et al. 2021

Preprint

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Background and aims: Capsule endoscopy (CE) is indicated in cases with obscure gastrointestinal bleeding (OGIB). However, lesions detected by CE are frequently within the reach of conventional upper or lower GI endoscopy. We evaluated the accuracy of CE in the study of OGIB, examining the incidence of CE-detected non-small-bowel lesions (NSBL) missed by conventional endoscopy and studying its impact on patient management.Methods: We retrospectively analyzed 2010 CE procedures performed in a tertiary-care center (IBD-Unit Referral Centre in Bologna), comparing the findings on CE to those on prior colonoscopy and upper GI endoscopy performed within 3 months and two weeks of the CE procedure, respectively. We evaluated the impact of CE findings on patient management.Results: CE revealed abnormal findings in 1608 out of 2010 patients. Previously missed NSBLs were revealed on CE in 283 cases. Of these, 265 pre-CE endoscopic reports were found to not conform to reporting guidelines. NSBLs on CE led to management changes in 271 patients.Conclusion: This study confirms the utility of CE in patients with OGIB. However, in a considerable number of cases, CE identified lesions missed by conventional endoscopy, suggesting that a second look prior to CE may be appropriate in some patients.Name of registry and the registration number: The study protocol was approved by the Comitato Etico Indipendente dell’AOU di Bologna (n°173/2017/O/OssN)

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 86%

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Capsule Endoscopy in the Detection of Non-Small Bowel Lesions Missed by Endoscopy

Calabrese

Gelli

Dussias

et al. 2021

Preprint

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“…A recent study by Yung et al [22] found 42% of positive studies had signi cant lesions within reach of standard upper and lower endoscopy thus considered "missed" ndings. Other studies report lower rates of lesions outside the small bowel ranging 5%-30.3% [10,23]. Differences between study criteria used to determine a positive nding outside of the small bowel likely accounts for some of this variability.…”

Section: Discussionmentioning

confidence: 96%

Video Capsule endoscopy in patients with Iron Deficiency Anaemia: Experience at a Regional Australian Service

Furner¹,

Nagel²,

Pinidiyapathirage³

2021

Preprint

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Background Few studies have examined the diagnostic yield of video capsule endoscopy (VCE) in patients with iron deficiency anaemia (IDA). This retrospective study aims to identify the yield of VCE, distribution of VCE findings in IDA and factors predictive of positive findings among patients presenting to a gasteroendoscopy practice in regional Australia. Methods Findings of consecutive VCE studies between March 2017 and April 2020 performed in patients with unexplained IDA and negative conventional endoscopy were included in this retrospective analysis. All endoscopies were performed and reported by a single specialist physician. Relevant clinical data including demographics, medication use, haemoglobin and ferritin levels were extracted into a standardised spreadsheet with procedural findings. A positive diagnostic yield was considered when VCE diagnosed one or more lesions that could explain the IDA. Statistical analysis was used to determine variables correlated with definite VCE findings. Results In total 123 procedures were included. Mean age of the patients was 67.9 years. Mean haemoglobin and ferritin levels were 93.3 g/L and 11.9ug/L, respectively. Positive findings were present in 54.5% of patients with the most frequent finding being angiodysplasia (52.2%). Haemoglobin level was the only variable associated with a positive finding. A significant number of studies had significant findings outside the small bowel (41.8%), overwhelmingly within reach of conventional upper endoscopy (89.3%). Conclusions VCE is a valuable diagnostic modality in patients with IDA. Low haemoglobin was associated with a positive finding on VCE in this group of patients.

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“…This was in keeping with the findings of Innocenti et al, where a significant number of patients were found to have non-small bowel lesions which had been missed during initial bidirectional endoscopy. 12 This highlights the need to consider a second look endoscopy where doubt exists about the quality of initial endoscopy. This is particularly relevant in limited resource setting such as in ours due to the high cost associated with VCE.…”

Section: Discussionmentioning

confidence: 99%

Video capsule endoscopy: Initial experience from a tertiary care center in Sri Lanka

2021

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Background: Since its global introduction in 2000, capsule endoscopy (CE) has revolutionized the evaluation of small bowel disease. Aims and Objective: The aim of this study was to share our experience with CE including the findings and its diagnostic yield. Materials and Methods: A retrospective study was carried out at Colombo South Teaching Hospital of Sri Lanka. Data of patients who underwent CE from its initiation in 2017 until June 2020 were obtained from the hospital computer database. These included the patient demographics, indications for the study, quality of bowel preparation, and its findings. Results: The study included 54 patients with a mean age of 55 years. Mean gastric time and small bowel transit time were 52 and 272 min, respectively. Forty-five CE studies were done for the evaluation of small bowel bleeding and an abnormal study was found in 26 (57.78%) patients. Small intestinal ulcers and erosions were the most frequently found abnormality (n=16, 35.56%) followed by tumors (n=5, 11.11%). Active bleeding was evident in 14 (31.11%) patients. Overall diagnostic yield was higher in those with a history of overt bleeding (n=15, 71.43%) compared to occult bleeding (n=11, 45.83%). Most patients who were evaluated for abdominal pain and diarrhea had normal CE except for two who had small intestinal ulcers and subepithelial lesions. Only one case was complicated with capsule retention. Conclusion: CE is a useful investigation for the evaluation of small bowel disease, particularly in suspected small bowel bleeding. In contrast to western population, ulcers and erosions were the more frequently found abnormalities seen in local setting.

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Non-small-bowel lesions identification by capsule endoscopy: A single centre retrospective study

Cited by 11 publications

References 35 publications

Capsule Endoscopy in the Detection of Non-Small Bowel Lesions Missed by Endoscopy

Capsule Endoscopy in the Detection of Non-Small Bowel Lesions Missed by Endoscopy

Video Capsule endoscopy in patients with Iron Deficiency Anaemia: Experience at a Regional Australian Service

Video capsule endoscopy: Initial experience from a tertiary care center in Sri Lanka

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