Diagnostic Value Of Capsule Endoscopy Research Articles

Comparison of the Diagnostic Value of Capsule Endoscopy and Traditional Electronic Endoscopy for Pediatric Digestive Tract Diseases

Comparison of the Diagnostic Value of Capsule Endoscopy and Traditional Electronic Endoscopy for Pediatric Digestive Tract Diseases

The diagnostic value of capsule endoscopy in children with intestinal lymphangiectasia.

intestinal lymphangiectasia is an unusual cause of protein-losing enteropathy due to either congenital malformation or obstruction of the intestinal lymphatics. However, few reports have investigated the use of video capsule endoscopy in children with intestinal lymphangiectasia. This study was performed to evaluate the diagnostic value of video capsule endoscopy for pediatric intestinal lymphangiectasia. in this retrospective study, all patients who underwent video capsule endoscopy between January 2014 and July 2020 were included. Clinical information and video capsule endoscopy data were analyzed. twelve children were enrolled, 7 males and 5 females, with an age at disease onset of 4.5 (range: 3.2-9.3) years and a disease duration of 12.0 (range: 1.3-30.0) months. The most common symptoms were hypoproteinemia (10, 83.3 %), diarrhea (7, 58.3 %), edema (6, 50.0 %), and abdominal pain (3, 25.0 %). Eight patients had low lymphocyte counts, whereas 10 had reduced serum albumin levels (23.2 ± 5.8 g/L). Video capsule endoscopy revealed an overall white snowy appearance due to the presence of whitish, swollen villi in all patients. Regarding the macroscopic lesions of lymphangiectasia, 7 cases involved the entire small bowel from the duodenum to the ileocecal valve, while 5 cases involved part of the small bowel. All patients were treated with medium-chain triglyceride diets, and albumin infusions were administered to 10 patients; sirolimus treatment was administered to 3 patients. At the last follow-up, 5 patients still had hypoalbuminemia and one patient had died of intestinal lymphoma. video capsule endoscopy is useful for the diagnosis of intestinal lymphangiectasia and should be applied as a valuable and less invasive examination to confirm or establish a diagnosis.

Синдром Пейтца–Егерса как причина железодефицитной анемии у ребенка 5 лет: диагностическое значение видеокапсульной энтероскопии

This clinical case demonstrates the diagnostic value of capsule endoscopy for the detection of polyposis of gastro-intestinal tract (Peutz–Jeghers syndrome). We report the case of a 5-year-old male presenting with a chronic iron refractory iron deficiency anemia. Multiple polyps of the stomach and small intestine with an erosive and hemorrhagic component were identified by the method of capsule endoscopy.

P260. Diagnostic value of capsule endoscopy in small bowel Crohn’s disease following normal radiological imaging

P260. Diagnostic value of capsule endoscopy in small bowel Crohn’s disease following normal radiological imaging

Diagnostic value of capsule endoscopy combined with computed tomography enterography for small intestinal diseases

Diagnostic value of capsule endoscopy combined with computed tomography enterography for small intestinal diseases

The diagnostic value of capsule endoscopy for asymptomatic NSAID–induced enteropathy

Objective To study the diagnostic value of capsule endoscopy for asymptomatic non–steroid antiinflammatory drugs(NSAID)–induced enteropathy. Methods A total of 110 health exam cases(38 cases taking NSAID orally)were recruited to the study and underwent capsule endoscopy. The incidence of small intestine lesion of NSAID takers and non–NSAID takers, that of those whose medication time longer than 3 months and less than 3 months, and who took low dose asprin and who took non–asprin NSAID were compared. The location of mucosal lesions and recovery status were followed up. Results The incidence of small intestine lesions was significantly different between NSAID group(55.3%, 21/38) and non–NSAID group(5.6%, 4/72)(P<0.01). The incidence of small intestine lesion was significantly higher in the over–three–month–medication group than in the less–than–three–month group(7/24 VS 4/14, P=0.01). The incidence of small intestine lesions was also significantly higher in the non–asprin group than asprin group(11/14 VS 10/24, P<0.05). The ulcerative lesions were predominantly located in the ileum(10/11), while the erosive lesions were predominantly found in the jejunum(8/10). Eight ulceration cases recovered after stopping taking NSAID or the use of rebamipide. Four erosion cases recovered after the use of rebamipide. Conclusion Capsule endoscopy is of favourable diagnostic and therapeutic value for asymptomatic NSAID–induced enteropathy. Key words: Small intestine; Non–steroid antiinflammatory drugs; Aspirin; Capsule endoscopy; Endoscopy

Metastatic Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs) of Unknown Primary: A Diagnostic Strategy for Localizing the Primary Lesion

Background: Localization of primary GEP-NETs is a diagnostic challenge of paramount importance, as resection of the primary lesion may increase treatment efficacy and improve prognosis. Aims: To evaluate the diagnostic value of capsule endoscopy (CE), double balloon enteroscopy (DBE), endoscopic ultrasound (EUS), octreotide scan (OS) and PET-CT for localizing primary GEP-NETs. Methods: Retrospective evaluation of patients with metastatic GEP-NETs and an unknown primary per CT or MRI. These patients had at least one of the 5 diagnostic modalities for localization. Tissue diagnosis was used to confirm the primary lesion. Results: 39 patients with biopsy-proven metastatic GEP-NET were referred to our center for a diagnostic evaluation between July 2002 and September 2010. The mean age was 58, 56% female. We ultimately identified the primary in 30 patients (77%) with various combinations of CE, DBE and EUS. CE was positive in 11/22 patients (50%), 8 of whom were confirmed. DBE was positive in 17/27 procedures (63%) and performed in a total of 22 patients. EUS, usually done after a negative intestinal search, was positive in 11/27 (65%). Octreotide scans were positive in 12/23 patients (52%) with 9 confirmations. 7 patients underwent all 3 endoscopic procedures; 6/7 patients (84%) had the primary localized. Overall, the sensitivities of CE, DBE and EUS were 60% 73% and 77%, respectively (see table). OS, typically considered the gold standard, had a sensitivity of only 59%. PET-CT scans were done on 4 patients and all were negative. Conclusions: CE, DBE, and EUS are highly effective in identifying the primary lesion for patients with metastatic GEP-NETs of unknown primary, especially when all three modalities are utilized. OS is imprecise in localizing lesions and may be less sensitive than any of the 3 endoscopic procedures. The value of PET-CT in the search for the primary lesion remains to be determined. Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of Each Procedure for Detection of Primary Lesions

Clinical value of capsule endoscopy in obscure gastrointestinal bleeding

To investigate clinical diagnostic value of capsule endoscopy in obscure gastrointestinal bleeding. Capsule endoscopy were performed in 90 patients with obscure gastrointestinal bleeding, which was defined as negative finding by gastroscopy and colonoscopy in our hospital. In 90 patients, 2 of them accepted second examination. Eighty-seven of 92 (94.57%) patients accepted of capsule endoscopy successfully including 21 of 25 (84.0%) in group of acute massive bleeding and 66 of 67 (98.51%) in recurrent melena (P <0.05). In above patients, 74 of 87 (85.06%) had positive findings and the false negative rate was 17.24%. The detectable rate in acute massive bleeding and recurrent melena was 80.95% and 86.36%, respectively (P >0.05), and the false negative rate of that was 23.81% and 15.15%, respectively (P >0.05). Capsule endoscopy can be performed safely and well-toleratedly for visualizing the small bowel in patients with obscure gastrointestinal bleeding, which induces a highly detectable rate compared with other methods for detecting obscure gastrointestinal bleeding.

Diagnostic Value of Capsule Endoscopy in Community Setting &amp; Its Effects in Altering the Management

Diagnostic Value of Capsule Endoscopy in Community Setting &amp; Its Effects in Altering the Management

Application of Capsule Endoscopy in Small Intestine Diseases: Analysis of 28 Cases in Kaohsiung Medical University Hospital

Capsule endoscopy (CE) is used to diagnose small intestine disease. Many studies have shown a better lesion detection rate in obscure gastrointestinal (GI) bleeding than with other surveyed techniques. Our study investigates the diagnostic value of CE in patients with suspicious small intestine diseases. Between October 2004 and January 2006, patients who had suspected small intestine disease underwent CE in Kaohsiung Medical University Hospital. Presenting symptoms included obscure GI bleeding, abdominal pain, diarrhea, microcytic anemia, and other indications. CE results were analyzed as a proportion of total lesion detection rate and also with regard to obscure GI bleeding and abdominal pain for analysis. A total of 28 patients, including 12 males and 16 females, were enrolled for CE examination. Overall, small intestine lesions were detected in 20 cases (71.4%), with negative findings in eight cases. For obscure GI bleeding, the total lesion detection rate was 85.7% (12 of 14 patients) but the diagnostic rate was only 35.7% (five of 14 cases). In patients with abdominal pain, four of seven (57.1%) had small intestine lesions. In conclusion, CE survey has a good lesion detection rate for small intestine disease, especially for patients with obscure GI bleeding, and is helpful in the diagnosis of unexplained abdominal pain.

Capsule Endoscopy for Gastrointestinal Bleeding with an Obscure Etiology

Capsule endoscopy (CE) is a new diagnostic modality that is being utilized with increasing frequency for examination of lesions suspected to be of small bowel origin. The most common indication for CE is obscure gastrointestinal bleeding. This study investigated the safety and diagnostic value of CE in patients with obscure gastrointestinal bleeding. From February 1 to October 30, 2003, 35 patients with obscure gastrointestinal bleeding among 43 consecutive patients with suspected small bowel pathology were enrolled. The mean age of the patients was 50.5 years (range, 24-81 years). A negative panendoscopy and colonoscopic study were required for study eligibility. An M2A video capsule endoscope was swallowed by each patient after an overnight fast if plain abdominal radiograph done 1 day prior to the procedure was negative for obstruction. Bowel preparation using a mixed solution containing magnesium carbonate, citric acid anhydrous and potassium bicarbonate, and bisacodyl was performed only in selected patients. Abnormal findings were noted in 31 of 35 patients (89%), 20 (57.2%) of whom had gastrointestinal pathology explaining their symptoms. Only 12 (34%) of the 20 patients had lesions solely in the small bowel. Angiodysplasia was the most common source of bleeding (37%), followed by Crohn's disease (14%). Other findings included Osler-Weber-Rendu's disease, gastrointestinal stromal tumor, vascular ectasia and small bowel diverticulum. Three capsules became lodged and did not provide images during subsequent transit through the colon, but serial abdominal plain radiographs done every 3 days after capsule ingestion showed passage of the capsules had occurred by 1 week. No discomfort or side effects were noted up to 2 months after ingestion. CE is a safe, painless and effective method for diagnosing obscure gastrointestinal bleeding. A final diagnosis was reached in more than one half of the patients and positively affected treatment. The capsule produced clear and recognizable images of lesions even without bowel preparation. If done early, CE can aid in directing proper management in patients with suspected small bowel pathology.

Wireless capsule endoscopy for obscure small-bowel disorders: Final results of the first pediatric controlled trial

Obscure small-bowel disorders are jejunal and ileal lesions undiagnosed by traditional imaging techniques (endoscopic, radiologic). We evaluated the diagnostic usefulness and safety of capsule endoscopy for obscure small-bowel disorders in children and adolescents. Comparative, prospective, self-controlled trials in patients (age, 10-18 y) suspected to have either small-bowel Crohn's disease, polyps, or obscure gastrointestinal (GI) bleeding. Capsule results were compared with the diagnostic imaging studies normally used in this age group. Among 20 patients suspected of Crohn's disease, multiple lesions consistent with this diagnosis were observed by capsule endoscopy in 50%. Small-bowel Crohn's disease was ruled out in 8 patients. Eosinophilic enteropathy was found in 2 others. For polyp detection (n = 6), capsule endoscopy yielded 100% concordance with the control studies when analyzed per patient. However, capsule endoscopy revealed a greater number (50%) of polyps. Among patients with obscure bleeding (n = 4), the capsule examination confirmed a diagnosis of vascular malformations in 3. Capsule endoscopy more accurately identified the precise source of bleeding compared with angiography. All 30 capsule studies were well tolerated, although 1 capsule was retained owing to an inflammatory stenosis. The capsule eventually was expelled after corticosteroid therapy. Capsule endoscopy correctly diagnosed or excluded a bleeding source, small-bowel polyps, or Crohn's disease of the small bowel in 29 of 30 patients. Capsule endoscopy permits an accurate, noninvasive approach for diagnosing obscure small bowel lesions in children over the age of 10.

Diagnostic Value of Capsule Endoscopy (CE) in Obscure Digestive Bleeding (ODB) and Effect of Erythromycin Injection

Diagnostic Value of Capsule Endoscopy (CE) in Obscure Digestive Bleeding (ODB) and Effect of Erythromycin Injection Dimitri Coumaros, Laurent Claudel, Patrick Levy, Michel Doffoel Aims : Evaluate the diagnostic yield of CE in ODB and the effect of erythomycin injection. Patients andmethods: In this prospective randomized study, 37 patients (pts) (mean age : 61 years) with an occult (n = 19) or overt (n = 18) ODB, were investigated by the Given M2A capsule, with (n = 19) or without (n = 18) intravenous injection of 3 mg/kg erythomycin, 30 to 60 min before CE. Colonic cleansing with 4 L PEG (n= 34) or 2 bottles of sodium phosphate (n = 3) ending 1 h before CE was undertaken. Lesions were classified according to their bleeding potential : nil (L0), probable (L1) or certain (L2) if an active bleedingwas visible. A single diagnosis per patient was delivered. Diagnostic agreement coefficient between a senior and a junior endoscopist was calculated based on 21 examinations. Gastric and small bowel transit times as well as the possibility of visualizing the colon were compared between the 2 groups. The duration of video analysis was measured. Results : 36 examinations out of 40 were valid (3 technical failures, 1 prolonged retention in the lower esophagus). The examination of 3 pts was repeated. 72 lesions L1 and 2 L2 were detected in 30 pts (83%). These pts had one type of lesion (n = 11), 2 (n = 15) or 3 types of different lesion (n = 4). The resulting diagnosis was angiectasias (n = 14), ulcerations (n = 7), red spots (n = 5), varix (n= 1), tumor (n= 1), nematodes (n= 1), polypoid angiectasia (n= 1). The location of these lesions was jejuno-ileal (n = 23), duodenal (n = 3), gastric (n = 1), colonic (n = 1) or multifocal (n = 2). The interobserver kappa coefficient was 0.64. The presence of red spots was linked to the presence of angiectasias (p<0.001). Erythromycin decreased the gastric time by 55 min (p<0.01) and increased the small bowel time by 70 min (p<0.03) without change of the rate of complete examination of the small bowel (84 vs 80%). Colonic visualization was allways limited to the caecum and ascending colon. Colonic cleansing was insufficient in 89% of pts. The duration of the video analysis decreased significantly after the first 24 examinations (63 vs 80 min; p<0.02). 2 cases of oral time superior to 5 min and 1 temporary blocage of the CE in the hypopharynx were noted. Conclusion : CE detected a bleeding or a potential bleeding lesion in 83% of pts. The resulting diagnosis concerned the stomach, the duodenum or the colon in 14% of the pts. Erythromycin reduced the gastric time without increasing the rate of complete examination of the small bowel. The exploration of the colon was limited to the caecum and ascending colon.