Video Capsule Endoscopy for Investigation of Obscure Gastrointestinal Bleeding: Feasibility, Results, and Interobserver Agreement

Leusse, A de; Landi, Bruno; Edery, Joël; Burtin, P; Lecomte, Thierry; Seksik, Philippe; Bloch, Florian; Jian, Raymond; Cellier, C.

doi:10.1055/s-2005-861419

Cited by 58 publications

(32 citation statements)

References 5 publications

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“…The authors used India ink to mark the exact position that they reached by the first approach [10]. This rate of complete examination of the small bowel was similar to the result with CE, which allowed the entire observation in 89% (57 of 64) of the patients, described by De Leusse et al in 2005 [1]. Possibly, the failures of CE were due to gastric retention, capsule technical problem or diffuse exudative enterophaty [1].…”

Section: Discussionmentioning

confidence: 86%

Is double-balloon enteroscopy an accurate method to diagnose small-bowel disorders?

et al. 2007

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Section: Discussionmentioning

confidence: 86%

Is double-balloon enteroscopy an accurate method to diagnose small-bowel disorders?

et al. 2007

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“…Demand was highest in patients with OGB (iron deficiency anemia, n = 104 patients; overt bleeding, n = 55 patients) and suspected active Crohn's disease (n = 68 patients). The average number of investigations per patient prior to CE was 4.3 (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. These investigations were in the form of upper gastrointestinal endoscopy, colonoscopy, push enteroscopy, small bowel studies, radionuclear scans, bone marrow aspirates, angiography, computed tomography, diagnostic laparoscopy, and even laparotomy.…”

Section: Indications For Capsule Endoscopymentioning

confidence: 99%

Capsule Endoscopy Changes Patient Management in Routine Clinical Practice

et al. 2007

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Our objective was to evaluate the diagnostic yield and effect of capsule endoscopy on patient management in routine clinical practice. Three hundred examinations were performed (176 females; mean age, 51 years), with a median follow-up of 17 months. Indications included overt bleeding (n=55), anemia (n=104), suspected Crohn's disease (n=68), celiac disease (n=35), suspected functional symptoms (n=23), polyposis (n=5), and miscellaneous (n=10). The overall diagnostic yield was 39%, but it was notably higher in overt bleeders, 66%, compared to 46% in the anemia group (P<0.025), 32% in the suspected Crohn's group (P<0.001), and 17% in the functional group (P<0.001). As a result of capsule endoscopy, management was altered in 26% of patients. This study shows that capsule endoscopy has both a high diagnostic yield and an impact on subsequent patient management. These data further support the role of capsule endoscopy in routine clinical practice.

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“…An incomplete VCE may be caused by gastric retention, slow bowel transit and residual small bowel content blurring vision (19). Efforts are being made to control the transit of the capsule and to optimize cleansing of the small bowel (20,21).…”

Section: The Proceduresmentioning

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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Video Capsule Endoscopy for Investigation of Obscure Gastrointestinal Bleeding: Feasibility, Results, and Interobserver Agreement

Cited by 58 publications

References 5 publications

Is double-balloon enteroscopy an accurate method to diagnose small-bowel disorders?

Is double-balloon enteroscopy an accurate method to diagnose small-bowel disorders?

Capsule Endoscopy Changes Patient Management in Routine Clinical Practice

Capsule enteroscopy and radiology of the small intestine

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