Use of Video Capsule Endoscopy in the Setting of Recurrent Subacute Small-Bowel Obstruction

Abstract

"Use of video capsule endoscopy in the setting of recurrent subacute small-bowel obstruction." Journal of Laparoendoscopic & Advanced Surgical Techniques.18,5. 713-716. (2008 AbstractHypothesis: Video capsule endoscopy (VCE) can be used to diagnose subacute intestinal obstruction in patients with otherwise negative imaging studies. Patients and Methods: Nine patients with symptoms consistent with intermittent small-bowel obstruction who received a VCE and ultimately required surgical intervention. Results: Patients were identified who had symptoms consistent with subacute bowel obstruction and a negative diagnostic work-up prior to VCE. All 9 patients underwent several radiologic and endoscopic examinations with no clear etiology for their symptoms. Ultimately, in every case, a stricture or mass was found to be the cause of the obstruction at either the time of VCE or exploratory laparotomy/laparoscopy. Conclusions: Patients can have a small-bowel stricture or mass that can cause symptoms of subacute smallbowel obstruction. Diagnosis of the lesion may be difficult in these patients and can often result in multiple nondiagnostic radiologic and endoscopic examinations. VCE can be helpful in finding these lesions, leading to surgical resection of the diseased bowel and a cure for the patient's signs and symptoms. 713

Small bowel capsule endoscopy in clinical practice

“…Although several studies [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] and two metaanalyses [47,48] have addressed this issue, there are no guidelines yet concerning the preparation before capsule endoscopy. Our survey shows that the large majority of patients (80%) take laxatives before the procedure.…”

“…It occurs overall in about 1-2.5% [27,32] of patients undergoing this examination, but this complication can reach 20-25% in some selected groups of patients (i.e. patients with small bowel obstruction or small bowel tumors) [33][34][35]. To ascertain the true impact of capsule retention in everyday clinical practice these data should be collected in a large multicenter setting and, possibly, covering a long period of time.…”

The Diagnostic Effect of Capsule Endoscopy in 31 Cases with Subacute Small Bowel Obstruction

“…In contrast, some authors have reported that NSAID-induced stricture was the major cause of capsule retention [6,7] . Recently, Mason et al [8] have reported that intestinal mass or radiation enteritis are the main causes of subacute small bowel obstruction. The different causes of stricture may be associated with the indications of the patients.…”

Small Bowel Capsule Endoscopy

“…With the premise that the retained capsule leads to surgical treatment of the diseased bowel and removal of capsule to alleviate the symptoms, CE has been used in the setting of recurrent subacute small bowel obstruction to find the cause of symptoms and localise the disease [414,415]. Ultimately, surgical intervention is required in most cases of capsule retention due to underlying pathology requiring surgical resection such as small bowel tumours [359,372,373], and also to deal with complications such as small bowel obstruction or perforation.…”