A Survey of Clinical Experience of Video-Capsule Endoscopy in a University Hospital

Abstract

Purpose: Wireless video capsule endoscopy (VCE) is a new technology that enables us to visualize the entire small bowel mucosa. It involves swallowing a video capsule endoscope, which is painless and relatively safe. Its use has been established for suspected small bowel bleeding, and the role of capsule endoscopy in the investigation of inflammatory bowel disease, iatrogenic disease, polyposis syndromes and celiac disease is evolving. Aim: To describe the overall experience of video capsule endoscopy in a large tertiary care center. Methods: All charts of patient who underwent VCE between 2001 and 2005 were retrospectively reviewed. There were 466 charts available with the complete VCE reports. Results: There were 466 patients who underwent VCE. The mean age was 59.5 years (range 7–90). There were 265 female patients and 201 male patients. The most common indication for the procedure was obscure gastrointestinal bleeding (84.9%), followed by abdominal pain (8.8%), Crohn's (7.1%), diarrhea (5.4%) and abnormal imaging (3.2%). A possible cause of obscure gastrointestinal bleeding was identified in 76.8% of patients. VCE identified a possible cause of abdominal pain and diarrhea in 41.8% and 28% respectively. 16% of patients with diarrhea were found to have newly diagnosed Crohn's. 57.6% of patients with colonic Crohn's disease were found to have small bowel involvement. The etiology of abnormal imaging was found in 60% of patients. Small intestinal mass was identified in 3.6% of patients and 88.3% of these patients presented with obscure gastrointestinal bleeding. Conclusions: VCE is a clear choice for evaluation of obscure gastrointestinal bleeding VCE is an important tool in diagnosing previously unrecognized Crohn's disease. VCE is an important tool in diagnosing upper gastrointestinal involvement in established colonic Crohn's disease. VCE is an important supplementary diagnostic tool in investigating not only obscure gastrointestinal bleeding but also Crohn's disease.