Value of the patency capsule in pre‐evaluation for capsule endoscopy in cases of intestinal obstruction

Small‐bowel capsule endoscopy (SBCE) is used widely because of its non‐invasive and patient‐friendly nature. SBCE can visualize entire small‐intestinal mucosa and facilitate detection of small‐intestinal abnormalities. In this review article, we focus on the current status of SBCE. Several platforms for SBCE are available worldwide. Third‐generation SBCE (PillCam® SB3) has a high‐resolution camera equipped with an adaptive frame rate system. Several software modes have been developed to reduce the reading time for capsule endoscopy and to minimize the possibility of missing lesions. The main complication of SBCE is capsule retention. Thus, the main contraindication for SBCE is known or suspected gastrointestinal obstruction unless intestinal patency is proven. Possible indications for SBCE are obscure gastrointestinal bleeding, Crohn's disease, small‐intestinal polyps and tumors, and celiac disease. Colon capsule endoscopy (CCE) can observe inflamed colonic mucosa non‐invasively, and allows for the continuous and non‐invasive observation of the entire intestinal tract (pan‐endoscopy). Recently, application of CCE as pan‐enteric endoscopy for inflammatory bowel diseases (including Crohn's disease) has been reported. In the near future, reading for CE will be assisted by artificial intelligence, and reading CE videos for long periods will not be required.

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“…The first prospective feasibility study of PC was reported by Spada et al . The efficacy of PC has been reported …”

Section: Pcmentioning

confidence: 99%

“…73 The first prospective feasibility study of PC was reported by Spada et al 71 The efficacy of PC has been reported. 67,71,[73][74][75][76] 36 with permission. Omni mode compares the target image with reference image A and analyzes the areas of the target image covered by reference image A.…”

Section: Pcmentioning

confidence: 99%

Capsule endoscopy for small‐intestinal disorders: Current status

Hosoe

Takabayashi

Ogata

et al. 2019

Digestive Endoscopy

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“…This is a dissolving capsule (the same size and shape as the capsule endoscope) containing a radiofrequency tag. Failure to detect the radio frequency signal using a handheld scanner 30 h after ingestion suggests functional patency of the GI tract and predicts uncomplicated excretion of the capsule 18 19Cautions and contraindications to small bowel capsule endoscopy

Crohn's disease

Prolonged non-steroidal anti-inflammatory drug use

Severe abdominal pain or obstructive sounding symptoms

Previous abdominopelvic radiotherapy

Altered upper gastrointestinal anatomy

Dysphagia

…”

Section: Practical Considerationsmentioning

confidence: 99%

Practical aspects of delivering a small bowel endoscopy service in the UK

Hale

Davison

Panter

et al. 2015

Frontline Gastroenterol

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Capsule endoscopy remains at the forefront of small bowel investigation, offering the only non-invasive means of directly imaging the mucosa of the small bowel. Recommended for the investigation of obscure gastrointestinal bleeding, Crohn's disease, coeliac disease, small bowel tumours and hereditary polyposis syndromes, the uptake of small bowel capsule endoscopy has been widespread in the UK. However, despite a wealth of published literature supporting the utility of capsule endoscopy in clinical practice, there are limited data regarding the actual practical aspects of service delivery, training and quality assurance. In this article, we attempt to address this by considering specific factors that contribute to provision of a high-quality capsule service. The role of formal training, accreditation and quality assurance measures is also discussed.

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“…According to an analysis of published cases of suspected small bowel stricture, in which 203 patients were included, the patency capsule has a very high sensitivity (97%) and a specificity (83%) of confirming the patency of the gastrointestinal tract before videocapsule endoscopy examination [20]. Importantly, it is not a risk-free procedure, as there have been reported cases of temporary intestinal occlusion and in a study conducted on 22 patients evaluating the usefulness of the patency capsule in patients with suspected small bowel stenosis, 3 patients had intestinal occlusion which required emergency surgery in 2 [21].…”

Section: Discussionmentioning

confidence: 99%

Is the use of AGILE patency capsule prior to videocapsule endoscopy useful in all patients with spondyloarthritis?

Gheorghe

Zahiu

Voiosu

et al. 2017

Romanian Journal of Internal Medicine

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Background and aims. As already known, spondyloarthritis patients present a striking resemblance in intestinal inflammation with early Crohn's disease. Moreover, the frequent use of nonsteroidal anti-inflammatory drugs is an important part of their treatment. Both conditions could lead to intestinal stenoses. Therefore we proposed to investigate the usefulness of the patency capsule test in patients with spondyloarthritis.Material and methods. 64 consecutive patients (33 males; mean age 38 ± 11 years) that fulfilled the AMOR criteria for seronegative spondyloarthropathy (59.4% ankylosing spondylitis) lacking symptoms or signs of intestinal stenosis were enrolled and submitted to an AGILE™ capsule patency test followed by a video capsule endoscopy (PillCam SB2™), as part of a protocol investigating the presence of intestinal inflammatory lesions. After reviewing the VCE recordings, the Lewis score (of small bowel inflammatory involvement) was computed.Results. In only 5 patients (7.8%) of the study group, the luminal patency test was negative. However, there was no retention of the videocapsule in any of the patients. From the 59 patients with a positive patency test, 3 patients presented single small bowel stenoses (two with ulcerated overlying inflamed mucosa, one cicatricial), all being traversed by the videocapsule along the length of the recording. None of the patients with a negative test had bowel stenoses. There was no correlation between the patency test and the Lewis score, the C reactive protein value, diagnosis of inflammatory bowel disease, or the family history of spondyloarthritis, psoriasis or inflammatory bowel disease.Conclusion. The AGILE patency capsule does not seem to be a useful tool for all patients with spondyloarthritis prior to small bowel videocapsule endoscopy (ClinicalTrial.gov ID NCT 00768950).

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Value of the patency capsule in pre‐evaluation for capsule endoscopy in cases of intestinal obstruction

Abstract: PC may be of diagnostic value in confirming the patency of the GI tract before capsule endoscopy. The routine use of PC might eliminate the contraindication of capsule endoscopy in many cases of intestinal obstruction.

Cited by 32 publications

References 25 publications

Capsule endoscopy for small‐intestinal disorders: Current status

Capsule endoscopy for small‐intestinal disorders: Current status

Practical aspects of delivering a small bowel endoscopy service in the UK

Is the use of AGILE patency capsule prior to videocapsule endoscopy useful in all patients with spondyloarthritis?

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