Route selection for double-balloon endoscopy, based on capsule transit time, in obscure gastrointestinal bleeding

Nakamura, Masanao; Ohmiya, Naoki; Shirai, Osamu; Takenaka, Hiroyuki; Morishima, Keisuke; Miyahara, Ryoji; Ando, Takafumi; Watanabe, Osamu; Itoh, Akihiro; Hirooka, Yoshiki; Goto, Hidemi

doi:10.1007/s00535-010-0202-z

Cited by 35 publications

(27 citation statements)

References 35 publications

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“…The other advantage of VCE is its ability to indicate the nearest DBE route (antegrade or retrograde). The candidate cut‐off value for the route selection is half of the small‐bowel transit time in the complete VCE examination, or 75% of the total time from ingestion to arrival at the cecum . VCE has a diagnostic yield for OGIB that varies from 41% to 80% when compared with what has been considered the gold standard in small bowel visualization, DBE .…”

Section: Diagnosismentioning

confidence: 99%

Obscure gastrointestinal bleeding: Diagnosis and treatment

Ohmiya

Nakagawa

Nagasaka

et al. 2015

Digestive Endoscopy

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Small-bowel bleeding comprises a majority of obscure gastrointestinal bleeding, but is caused by various kinds of diseases. For its diagnosis, history-taking and physical examination is requisite, leading to a suspicion of what diseases are involved. Next, cross-sectional imaging such as computed tomography should be done, followed by the latest enteroscopy, videocapsule endoscopy and deep enteroscopy according to the severity of hemorrhage and patient conditions. After comprehensive diagnosis, medical, enteroscopic, or surgical treatment should be selected.

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Section: Diagnosismentioning

confidence: 99%

Obscure gastrointestinal bleeding: Diagnosis and treatment

Ohmiya

Nakagawa

Nagasaka

et al. 2015

Digestive Endoscopy

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“…DBE was generally performed as previously described (11,12). Key exclusion criteria included the following: (1) patients in whom it was difficult to reach the small intestine by endoscopy, (2) patients who had a poor general condition, namely, severe anemia, hypoalbuminemia, or fasting for more than one week, (3) patients from whom it was difficult to obtain informed consent, and (4) patients whom the physician judged to be ineligible.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the mRNA and Protein Expressions of Nutritional Biomarkers in the Gastrointestinal Mucosa of Patients with Small Intestinal Disorders

et al. 2016

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Objective The objectives of this study were to investigate the mRNA and protein expression of biomarkers related to absorption in the small intestinal mucosa of humans and determine the relationships between small intestinal diseases and nutrition. Methods The study subjects consisted of patients scheduled to undergo double-balloon endoscopy (DBE) or total colonoscopy for suspected gastrointestinal disorder in a clinical practice. Biopsies were taken from apparently normal mucosa in the visible areas of 6 parts of the intestines from the duodenum to the colon. The mRNA expression of specific biomarkers (SGLT1, SGLT5, GIP, GLP, LAT1, LAT2, and NPC1L1) in the mucosa was compared among three patient groups: Inflammation, Tumor, and Control. Results Sixty-six patients participated in this study. Both routes of DBE were performed in 20 patients, in whom biopsy samples were obtained from the mucosa for all sections. There were no remarkable differences in the mRNA expression levels among the 3 groups. However, SGLT1, GIP, GLP, and NPC1L1 exhibited specific distribution patterns. The expression levels of GIP and NPC1L1 were highest in the upper jejunum, but were extremely low in the terminal ileum and colon. A comparison of the mRNA expression profile in each intestinal section revealed that the SGLT1 mRNA expression in the Tumor group and the GIP mRNA expression in the Inflammation group were significantly higher than the corresponding levels in the Control group in the upper jejunum. Conclusion The gastrointestinal mucosa of patients with small bowel diseases can maintain proper nutrient absorption, except in the upper jejunum.

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“…DBE was performed according to the method described in detail by Yamamoto et al [23]. In general, the route of insertion (either peroral or peranal) was dictated by the findings of MR enteroclysis and VCE [24]. …”

Section: Methodsmentioning

confidence: 99%

Comparison of MR enteroclysis with video capsule endoscopy in the investigation of small-intestinal disease

et al. 2012

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PurposeTo evaluate the diagnostic accuracy of MR enteroclysis and to compare it to video capsule endoscopy (VCE) in the analysis of suspected small-bowel disease.MethodsWe performed a retrospective analysis of 77 patients who underwent both MR enteroclysis and VCE and compared the findings of these studies with the findings of enteroscopy, surgery, or with the results of clinical follow-up lasting ≥2 years.ResultsFindings included malignant neoplasms (n = 13), benign neoplasms (n = 10), refractory celiac disease (n = 4), Crohn’s disease (n = 2) and miscellaneous conditions (n = 10). Specificity of MR enteroclysis was higher than that of VCE (0.97 vs. 0.84, P = 0.047), whereas sensitivity was similar (0.79 vs. 0.74, P = 0.591). In 2/32 (6.3%) patients with both negative VCE and negative MR enteroclysis a positive diagnosis was established, compared to 5/11 (45.5%) patients in whom VCE was positive and MR enteroclysis was negative (likelihood ratio 8.1; P = 0.004), 9/11 (81.8%) patients in whom MR enteroclysis was positive and VCE was negative (likelihood ratio 23.5; P < 0.0001), and all 23 patients in whom both VCE and MR enteroclysis showed abnormalities (likelihood ratio 60.8; P < 0.0001).ConclusionsVCE and MR enteroclysis are complementary modalities. In our study-population, MR enteroclysis was more specific than VCE, while both produced the same sensitivity.

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Route selection for double-balloon endoscopy, based on capsule transit time, in obscure gastrointestinal bleeding

Abstract: The VCE transit time was useful for determining the route for DBE in OGIB. This parameter was most accurate when the cutoff value for the selection was half of the small-bowel transit time in the complete VCE examination.

Cited by 35 publications

References 35 publications

Obscure gastrointestinal bleeding: Diagnosis and treatment

Obscure gastrointestinal bleeding: Diagnosis and treatment

Evaluation of the mRNA and Protein Expressions of Nutritional Biomarkers in the Gastrointestinal Mucosa of Patients with Small Intestinal Disorders

Comparison of MR enteroclysis with video capsule endoscopy in the investigation of small-intestinal disease

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