Clinical Utility of Wireless Capsule Endoscopy

Tatar, Eric L.; Shen, Eric; Palance, Adam L.; Sun, John; Pitchumoni, C. S.

doi:10.1097/01.mcg.0000196185.11802.b2

Cited by 33 publications

(19 citation statements)

References 19 publications

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“…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%

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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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Section: Double-balloon Enteroscopymentioning

confidence: 99%

“…So far, OGIB is the main clinical indication for capsule endoscopy; about 70%-80% of patients undergoing capsule endoscopy have OGIB (31,32).…”

Section: Wireless Capsule Endoscopymentioning

confidence: 99%

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

Graça¹,

Freire²,

Brito³

et al. 2010

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“…Among them, two non-invasive technologies, capsule endoscopy (CE) and multislice CT (MSCT) markedly improved the ability to determine the causes of OGIB by allowing the visualization of the gastrointestinal tract. 2,3,6 CE is able to obtain direct visualization of mucosal surface of the entire small intestine. 4,7,8 However, capsule retention remains a major risk of CE diagnosis.…”

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confidence: 99%

“…2,3 Based on the presence or absence of clinically evident bleeding, OGIB could be divided into occult (no visible blood) and overt (continued passage of visible blood, such as haematemesis, melaena or haematochezia) bleeding. 3,4 OGIB frequently occurs in the small bowel and is caused by small bowel diseases such as intestinal erosions, ulcers, vascular anomaly, gastrointestinal tumours and inflammatory bowel and parasitic diseases.…”

mentioning

confidence: 99%

Obscure gastrointestinal bleeding: diagnostic performance of 64-section multiphase CT enterography and CT angiography compared with capsule endoscopy

He¹,

Gong²,

Hu³

et al. 2014

BJR

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“…Despite its advantages, the diagnostic yield of CE may be restricted by some limitations. In almost 20–30% of the cases, the capsule does not reach the cecum within the imaging period [6,7,8]. This results in failure of visualization of the more distal small bowel.…”

Section: Introductionmentioning

confidence: 99%

Optimal Approach for Small Bowel Capsule Endoscopy Using Polyethylene Glycol and Metoclopramide with the Assistance of a Real-Time Viewer

Hosono

Endo²,

Shimizu³

et al. 2011

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Aim: Capsule endoscopy is limited by the poor image quality of the distal bowel and incomplete small bowel transit. The aim of this study was to establish an optimal medication protocol for capsule endoscopy performed using a real-time viewer. Methods: A total of 80 patients were prospectively recruited. The patients were randomized into two groups: the ‘conventional group’ (without any preparation) and the ‘real-time group’ (in which a real-time viewer was attached). At 60 min after swallowing the capsule, if the capsule hadreached the small bowel, 500 ml of polyethylene glycol was administered; if the capsule was still located in the stomach, 10 mg of metoclopramide was given intramuscularly, followed by 500 ml of polyethylene glycol solution. Results: The completion rate was significantly higher in the real-time group as compared with that in the conventional group (72.5 vs. 90.0%). Our protocol yielded a significantly improved image quality of the distal small bowel [image quality score = 1.6 vs. 3.0 (max 4.0)]. The detection rate of lesions in the distal small bowel was higher in the real-time group than in the conventional group. Conclusions: The present study clearly showed that our protocol yielded an improved completion rate and also improved image quality.

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Clinical Utility of Wireless Capsule Endoscopy

Abstract: Wireless capsule endoscopy is a valuable diagnostic tool in the evaluation of occult small bowel lesions, and was most effective in patients with gastrointestinal hemorrhage and anemia.

Cited by 33 publications

References 19 publications

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

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

Obscure gastrointestinal bleeding: diagnostic performance of 64-section multiphase CT enterography and CT angiography compared with capsule endoscopy

Optimal Approach for Small Bowel Capsule Endoscopy Using Polyethylene Glycol and Metoclopramide with the Assistance of a Real-Time Viewer

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