Small Bowel Exploration by Wireless Capsule Endoscopy: Results from 314 Procedures

Sturniolo, Giacomo Carlo; Leo, Vincenza Di; Vettorato, Maria Grazia; Boni, Michele De; Lamboglia, Francesca; Bona, Manuela De; Bellumat, Angelo; Martines, Diego; D’Incà, R.

doi:10.1016/j.amjmed.2005.08.029

Cited by 47 publications

(29 citation statements)

References 32 publications

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“…The transit time and cecal completion rate of capsule endoscopy vary considerably, depending on bowel motility, because the capsule is only transported passively through the gastrointestinal tract. Incomplete examination of the small bowel occurs in approximately 20-30% of the patients undergoing CE, because of the limited battery life of the endoscope unit [4,5]. This results in the failure to visualize the more distal small bowel, potentially leading to missed distal small bowel abnormality.…”

Section: Introductionmentioning

confidence: 97%

Abdominal Surgery Affects Small Bowel Transit Time and Completeness of Capsule Endoscopy

et al. 2008

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The aim of the study was to evaluate bowel dysmotility in patients with a history of abdominal surgery by measuring both gastric transit time and small bowel transit time during capsule endoscopy and assessing the completeness of the examination. The study included 26 patients who had undergone abdominal surgery (postoperative group) and 52 patients who had not (control group). The capsule reached the cecum in 50.0% of the postoperative group and 80.8% of the control group (P=0.005). While there was no significant difference in gastric transit time between the two groups (P=0.882), small bowel transit time was significantly longer in the postoperative group (338.3+/-119.2 min) than in the control group (266.4+/-110.8 min, P=0.010). This is the first study to report that the small bowel transit time during capsule endoscopy is prolonged in patients who had a history of abdominal surgery, resulting in a lower frequency of complete examination.

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Section: Introductionmentioning

confidence: 97%

Abdominal Surgery Affects Small Bowel Transit Time and Completeness of Capsule Endoscopy

et al. 2008

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“…Several studies have further supported the role of capsule endoscopy in the evaluation of OGIB, with an overall diagnostic yield between 50% and 70% (33)(34)(35).…”

Section: Wireless Capsule Endoscopymentioning

confidence: 99%

“…Disadvantages.-The main limitations of capsule endoscopy are the lack of air insufflation, the unavailability of rinsing, and the inability to perform biopsies or treat lesions (31,33,34). As with conventional endoscopy of the upper and lower GI tract, the presence of massive hemorrhage can obscure the bleeding site (21).…”

Section: Double-balloon Enteroscopymentioning

confidence: 99%

Gastroenterologic and Radiologic Approach to Obscure Gastrointestinal Bleeding: How, Why, and When?

Graça¹,

Freire²,

Brito³

et al. 2010

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Gastrointestinal (GI) bleeding is a common clinical condition that is increasingly seen in an aging population and frequently requires hospitalization and intervention, with significant morbidity and mortality. Obscure GI bleeding (OGIB) is defined as loss of blood with no source identified after upper endoscopy and colonoscopy. Whether an obscure site of bleeding is clinically evident or silent, it constitutes a diagnostic and therapeutic challenge for the clinician. Gastroenterology and radiology provide the essential diagnostic tools used to evaluate suspected OGIB, each with its strengths and weaknesses. Small bowel series and conventional enteroclysis have a limited role in OGIB. Computed tomographic (CT) enterography and CT enteroclysis are noninvasive techniques with promising results in evaluation of small bowel disease and silent OGIB. CT angiography is a useful triaging tool for diagnosing or excluding active GI hemorrhage, localizing the site of bleeding, and guiding subsequent treatment. Tagged red blood cell scanning is the most sensitive technique for detection of active GI bleeding and allows imaging over a prolonged period, making it useful for detecting intermittent bleeding. Capsule endoscopy has emerged as an important tool for investigating OGIB, but it may soon have competition from double-balloon enteroscopy, a diagnostic technique that can also facilitate therapy.

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“…With such single cases taken into account, the VCE is the examination of choice for the small bowel (72,73). The disposable capsule is readily ingested and allows for a complete, noninvasive endoscopic examination of the mucous membrane of the entire small bowel.…”

Section: Discussionmentioning

confidence: 99%

Capsule enteroscopy and radiology of the small intestine

Fork

Aabakken

2007

Eur Radiol

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Capsule Enteroscopy and Radiology of the Small Intestine 2 ABSTRACT In a very few years, the video capsule for small bowel enteroscopy has gained widespread clinical acceptance. It is readily ingested, disposable, and allows for a complete, low-invasive endoscopic examination of the entire mucosa of the small bowel. It is a patient-friendly method and a first line procedure in the difficult evaluation of obscure gastrointestinal bleeding. It has the highest proven figure of diagnostic sensitivity for detecting lesions of the mucosa, irrespective of aetiology. The limitations of capsule endoscopy include difficulty in localizing mucosal lesions anatomically and its restricted use in patients with dysphagia, strictures or motor dysfunction. Strictures, transmural and extra-mural lesions in patients with small bowel Crohn's disease are evaluated by MRI-enterography and CT-enterography.Capsule Enteroscopy and Radiology of the Small Intestine 3 Imaging of the small bowel was, until recently, the responsibility of the radiologist, who, in dedicated centres, offered the patient not just a small-bowel follow-through with single exposures over time, but a dedicated, real time, fluoroscopic examination of a well distended small bowel, displayed in double-contrast and documented on spot films (1). This enteroclysis technique, well accepted by gastroenterologists, significantly improved both the detection of mucosal disease and the mapping of involved bowel segments. However, the duration of the examination, discomfort related to nasojejunal intubation and infusion of large volumes of contrast and distension materials, be it methyl cellulose or air (2), reduced general acceptance and dissemination of this method (3). VCE has evolved to be the first line procedure in many hospitals (7-13), keeping small bowel radiology as method of choice for patients who cannot take the capsule (13). In order to understand the diagnostic algorithm of modern small bowel examination we will discuss the video capsule technique, its indications and contraindications, advantages and disadvantages, types of true and false lesions and comparative studies of VCE and radiological methods of investigation of the small intestine. The video capsuleVCE was primarily developed for examination of small bowel mucosa (14,15). Rapid technical refinement has since resulted in a dedicated capsule for the oesophagus, and recently capsules for the study of both stomach and colon (16).The capsule measures 11 by 27mm and includes a light source and a camera inside a clear, transparent dome, batteries and a radio-transmitter (Figure 1). Whilst ushered forward by peristalsis the capsule transmits images continuously at two frames per second for around eight hours, a total of more than 60.000 images. The image has a 140° field of view, a focus depth of 1-30 mm, and an 8:1 magnification (17). An array of eight external detectors, applied to the abdominal wall, receives the images for storage in a solid state data recorder. Capsule Enteroscopy and Radiology of the Smal...

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Small Bowel Exploration by Wireless Capsule Endoscopy: Results from 314 Procedures

Cited by 47 publications

References 32 publications

Abdominal Surgery Affects Small Bowel Transit Time and Completeness of Capsule Endoscopy

Abdominal Surgery Affects Small Bowel Transit Time and Completeness of Capsule Endoscopy

Gastroenterologic and Radiologic Approach to Obscure Gastrointestinal Bleeding: How, Why, and When?

Capsule enteroscopy and radiology of the small intestine

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