Yield Of Capsule Endoscopy Research Articles

Yield of capsule endoscopy and subsequent device-assisted enteroscopy: experience at an Australian tertiary centre.

Small bowel capsule endoscopy (SBCE) and device-assisted enteroscopy (DAE) have an established role in the investigation and management of small bowel pathology. Previous studies have reported on the yield of SBCE (60%) and DAE (57%), but none have been in an Australian setting. To determine the yield of SBCE and any DAE performed as a direct consequence of SBCE in an Australian referral centre. A single-centre retrospective study was conducted at a tertiary hospital in Australia, enrolling consecutive patients between 1 January 2009 and 31 December 2021 undergoing SBCE. Data were collected with respect to demographics, procedural factors and findings, as well as findings and interventions of any DAE procedures performed after the SBCE. 1214 SBCEs were performed, with a median age of 66 years old (60.8% men). The predominant indications were anaemia (n = 853, 70.2%) and overt gastrointestinal bleeding (n = 320, 26.4%). Of the complete small bowel studies (1132/1214, 93.2%), abnormal findings were detected in 588 cases (51.9%), most commonly angioectasias (266/588, 45.2%), erosions (106/588, 18.0%) and ulcers (97/588, 8.6%). 165 patients underwent a DAE (117 antegrade, 48 retrograde). Antegrade DAE had a higher yield than retrograde DAE (77.8% vs 54.2%; P = 0.002) and a higher rate of intervention (69.2% vs 37.5%; P < 0.001). In this largest single-centre cohort of patients undergoing SBCE to date, there is a similar yield of abnormal findings compared to existing literature. DAE, especially with an antegrade approach, had high diagnostic and therapeutic yield when pursued after a positive SBCE study.

The Diagnostic Yield of Capsule Endoscopy in Egyptian Patients with Obscure Gastrointestinal Tract Bleeding

The Diagnostic Yield of Capsule Endoscopy in Egyptian Patients with Obscure Gastrointestinal Tract Bleeding

Non-steroidal anti-inflammatory drug-induced enteropathy as a major risk factor for small bowel bleeding: a retrospective study

BackgroundSmall bowel (SB) bleeding accounts for 5% of all gastrointestinal (GI) bleeding cases and 80% of obscure GI bleeding cases. Although angioectasia is the common etiology of SB bleeding, nonsteroidal anti-inflammatory drug (NSAID)-induced SB lesions are also reported as a major cause in studies from Eastern countries. Herein, we assessed the frequency of occurrence of NSAID-induced SB lesions in Korean patients with obscure GI bleeding.MethodsWe retrospectively analyzed medical records of all consecutive patients aged ≥18 years who underwent capsule endoscopy from March 2018 to February 2019 at Ulsan University Hospital and Kosin University Gospel Hospital.ResultsOf the 83 subjects (all Korean; mean age ± standard deviation: 59 ± 18 years; age range: 18–84 years; men: n = 52; women: n = 31), 55 (66.2%) had stool with clear blood and 28 (33.8%) had normal stool with iron deficiency anemia. The detection rate of SB bleeding and lesions using capsule endoscopy was 72.3% (60 of 83 patients). A significantly higher frequency (40 of 51) of ulcerative/erosive lesions than other causes was observed in patients with inactive bleeding but visible SB lesions. As a result, NSAID-induced enteropathy accounted for 30.1% of 83 patients with obscure GI bleeding (25 of the all 60 SB bleeding cases).ConclusionsContrary to what is reported for patients in Western countries, this study in Korean patients showed an improved diagnostic yield of capsule endoscopy for obscure GI bleeding and that NSAID-induced enteropathy was the most common etiology of SB bleeding. Aggressive small intestine examination is required for patients with unexplained GI bleeding.

Yield of capsule endoscopy in obscure gastrointestinal bleeding: A comparative study between premenopausal and menopausal women.

AIMTo evaluate differences in capsule endoscopy (CE) performed in the setting of obscure gastrointestinal bleeding (OGIB) among premenopausal women (PMW) and menopausal women (MW).METHODSRetrospective, single-center study, including female patients submitted to CE in the setting of OGIB between May 2011 and December 2016. Patients were divided into 2 groups according to age, considering fertile age as ≤ 55 years and postmenopausal age as > 55 years. The diagnostic yield (DY), the rebleeding rate and the time to rebleed were evaluated and compared between groups. Rebleeding was defined as a drop of Hb > 2 g/dL or need for transfusional support or presence of melena/hematochezia.RESULTSA hundred and eighty three female patients underwent CE for OGIB, of whom 30.6% (n = 56) were PMW and 69.4% (n = 127) were MW. The DY was 30.4% in PMW and 63.8% in MW. The most common findings were angiodysplasias in both groups (PMW: 21.4%, MW: 44.9%) (P = 0.003). In PMW, only 1.8% required therapeutic endoscopy. In 17.3% of MW, CE findings led to additional endoscopic treatment. Rebleeding at 1, 3 and 5 years in PMW was 3.6%, 10.2%, 10.2% and 22.0%, 32.3% and 34.2% in MW. Postmenopausal status was significantly associated with higher DY (P < 0.001), TY (P = 0.003), rebleeding (P = 0.031) and lower time to rebleed (P = 0.001).CONCLUSIONPMW with suspected OGIB are less likely to have significant findings in CE. In MW DY, need for endoscopic treatment and rebleeding were significantly higher while time to rebleed was lower.

Diagnostic Yield of Capsule Endoscopy in Gastroduodenal and Small Bowel Disease: An Experience from a Local Hospital in Gaza Strip: Experience, Comparison to Other Existing Modalities and Utility as Capsule Gastroduodenoscopy

Diagnostic Yield of Capsule Endoscopy in Gastroduodenal and Small Bowel Disease: An Experience from a Local Hospital in Gaza Strip: Experience, Comparison to Other Existing Modalities and Utility as Capsule Gastroduodenoscopy

PTU-020 Diagnosing small bowel crohn’s disease – using capsule when the imaging is negative

Introduction The European Crohn’s and Colitis Organisation guidelines 1 state that small bowel capsule endoscopy (SBCE) should be reserved for patients in whom the clinical suspicion for Crohn’s disease remains high despite negative evaluations with ileocolonoscopy and radiological examinations. SBCE has been shown to detect a higher yield of non-stricturing small bowel Crohn’s disease compared to CT and small bowel barium radiology 2 and improved detection rates compared with MRI. 3 Southmead Hospital is a tertiary referral centre for SBCE which receives referrals throughout the Somerset region. We assessed the diagnostic yield from patients referred for CE for suspected Crohn’s Disease. Method All patients referred for SBCE to assess for small bowel Crohn’s disease between May 2013 and May 2014 were identified. Patients with known Crohn’s disease or positive findings on small bowel imaging were excluded. Patient demographics and CE findings were collected from patient notes, electronic results or referral information. CE videos were interpreted by one of three gastroenterology consultants experienced in interpreting SBCE video. Results 61 patients were referred for SBCE following negative small bowel imaging of which 14 (22.9%) patients had positive findings on SBCE. 9 (64.3%) were female (age range of 17–66 years; mean 42 years). 1 patient (7.1%) had pathology in the proximal SB, 2 (14.3%) in the mid SB, 6 (42.3%) in the distal SB whilst 6 (42.3%) had pathology throughout the SB. Prior to SBCE, 5 patients (35.7%) had negative small bowel MRI, 2 (14.3%) had negative CT abdomen, 5 had (35.7%) negative small bowel enema and 2 (14.3%) had both negative MRI and CT abdomen. Conclusion SBCE diagnosed Crohn’s disease in 22.9% of patients that was not detectable on small bowel imaging. In our experience, SBCE is a worthwhile investigation in patients in whom there is a high clinical suspicion of Crohn’s disease with previous negative imaging including small bowel MRI. Disclosure of interest None Declared. References Van Assche G, Dignass A, Panes J, Beaugerie L, Karagiannis J, Allez M, Stange E. The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis. J Crohns Colitis 2010;4(1):7–27 Triester SL, Leighton JA, Leontiadis GI, Gurudu SR, Fleischer DE, Hara AK, Sharma VK. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn’s disease. Am J Gastroenterol. 2006;101(5):954–964 Golder SK, Schreyer AG, Endlicher E, Feuerbach S, Scholmerich J, Kullmann F, Herfarth H. Comparison of capsule endoscopy and magnetic resonance (MR) enteroclysis in suspected small bowel disease. Int J Colorectal Dis. 2006;21(2):97–104

Clinical value of capsule endoscopy in obscure gastrointestinal bleeding

Objective Assessed the efficiency of capsule endoscopy in obscure gastrointestinal bleeding （OGIB） diagnosis and the reference value of diagnosis results in further clinical treatment, analyzed how capsule endoscopy results can affect patients＇ prognosis. Methods 307 consecutive patients who under- went capsule endoscopy for OGIB from June 2002 to October 2010 were enrolled. Follow-up data were ob- tained by reviewing medical records, capsule endoscopy database and contacting the patients or their relatives by telephone. We set validation criteria to calculate the capsule endoscopy inspection sensitivity, specificity, positive predictive value, negative predictive value, the accuracy. And by comparing the clinical treatment and prognosis of capsule endoscopy-positive patients with those of capsule endoscopy-negative ones, we ana- lyzed bow capsule endoscopy results can guide clinical treatment and its effect on prognosis. Results Among the patients who perform capsule endoscopy for OGIB, 307 patients follow-up data were available, with a medium follow-up of 52. 0 （range 13 -112, interquartile range 33 -74 ） months. In this study, the diagnostic yield of capsule endoscopy is 65.8% , and the accuracy is 84. 8%. Sensitivity, specificity, posi- tive predictive value and negative predictive value of capsule endoscopy were 81.7% , 91.4% , 95.2% and 70. 5%, respectively. The effective intervention rate of specific treatments in capsule endoscopy-postive pa- tients was 94. 5%, while the total effective intervention rate was 94. 7%. Conclusion Capsule endoscopy for OGIB is an effective and safe method with excellent tolerability as well as high diagnostic yield and accu- racy, able to effectively guide the clinicians to proper diagnosis and treatment, thus greatly improving the prognosis of these patients. Key words: Capsule endoscopes ; Diagnosis ; Early intervention; Prognosis ; Obscure gastro-intestinal bleeding

Feasibility of capsule endoscopy in elderly patients with obscure gastrointestinal bleeding. An up-to-date report

BackgroundAnemia is the most common hematologic abnormality in older populations. Furthermore, iron deficiency anemia is common and merits investigation and treatment, as it usually results from chronic occult bleeding from the gastrointestinal tract. In view of a wide use of capsule endoscopy as a diagnostic procedure for occult gastrointestinal bleeding and of the growth of aging population, we performed a literature review about the feasibility of capsule endoscopy in the elderly.MethodsWe conducted a literature search in the PubMed database in July 2012, and all English-language publications on capsule endoscopy in elderly patients since 2005 were retrieved. The potential original articles mainly focused on obscure gastrointestinal bleeding were all identified and full texts were obtained and reviewed for further hand data retrieving.ResultsWe retrieved only six papers based on different primary end-points. Four were retrospective non randomized studies and two were prospective non randomized studies. In the end 65, 70, 80 and 85 years were used as an age cut-off. All studies evaluate the diagnostic yield of capsule endoscopy in iron deficiency anemia. Only three studies assess the feasibility of capsule examination of the elderly.ConclusionsIron deficiency anemia in the elderly with or without obscure gastrointestinal bleeding is the major indication for capsule endoscopy after a negative esophago-gastro-duodenoscopy and colonoscopy. It is safe and effective to identify a small bowel pathology without a great discomfort for the elderly. Inability to swallow the capsule, battery failure before capsule reaches the cecum, and capsule retention are some of the important problems associated with capsule endoscopy in elderly as well as in younger patients.

MiroCam™ capsule for obscure gastrointestinal bleeding: A prospective, single centre experience

BackgroundCapsule endoscopy is an established tool for the evaluation of obscure gastrointestinal bleeding but published literature is mostly limited to PillCam™ SB (Given Imaging, Israel). AimsThe aims of this study were to determine the findings, the diagnostic yield and the rebleeding rate in a series of patients with overt or occult obscure gastrointestinal bleeding studied with MiroCam™ (Intromedic, Seoul, Korea) capsule endoscopy. MethodsData of 118 patients who underwent capsule endoscopy for overt or occult obscure gastrointestinal bleeding were prospectively collected between March 2009 and March 2011. ResultsEvaluation of the entire small bowel (completion rate) was achieved in 96% of cases. Relevant lesions occurred in 58% of patients. Angiodysplasias was the most common finding. Six patients (9% of the positive findings) had a non-small-bowel lesion detected by capsule. The yield of capsule endoscopy in the overt group was greater than in the occult group but without achieving a significant difference (61% vs. 54%, p>0.05). Rebleeding rate was lower in patients with a negative examination (6%) than in patients with a positive one (17%) (p=0.03). Capsule retention was registered in 3 of 118 patients (2.5%). ConclusionsMiroCam capsule endoscopy is a safe and effective tool for exploring small bowel with a high completion rate.

Sa1696 The Diagnostic Yield of Capsule Endoscopy and Findings in Patients With Obscure Gastrointestinal Bleeding in a Single Center in Latin America

Sa1696 The Diagnostic Yield of Capsule Endoscopy and Findings in Patients With Obscure Gastrointestinal Bleeding in a Single Center in Latin America

A Retrospective Analysis to Validate the Alarm Signs Used in the CEDAP-Plus Study

Background and Study Aim. This study aimed to validate the alarm signs used in the 2007 German CEDAP-Plus study for indicating capsule endoscopy in patients who have idiopathic chronic abdominal pain. Patients and Methods. We retrospectively reviewed the cases of all patients who underwent capsule endoscopy at our institution between August 2007 and August 2009 for chronic hitherto undiagnosed abdominal pain, despite previous investigations. The demographic data, indications, findings, and diagnoses were recorded, as were the alarm signs (i.e., 10% loss of weight within 3 months, suspected small intestinal bleed or chronic anemia, and laboratory indications of inflammation). Results. Alarm signs were found in only 4 of the 62 included patients. Capsule endoscopy revealed findings that led to diagnoses of Crohn's disease (n = 4), tuberculosis (n = 1), gastrointestinal stromal tumors (n = 3), and hookworm (n = 1); these diagnoses included 100% (4/4) of the patients with alarm signs, but only 8.6% (5/58) of patients without them. However, 55.6% (5/9) of patients with clinically capsule endoscopy findings reported no alarm signs. Conclusions. Although selecting patients based on the alarm signs may increase the yield of capsule endoscopy, the alarm sign criteria appear to have low sensitivity.

Diagnostic yield of capsule endoscopy in patients with obscure gastrointestinal bleeding or unexplained anemia - A monocenter experience with 1006 consecutive examinations

Diagnostic yield of capsule endoscopy in patients with obscure gastrointestinal bleeding or unexplained anemia - A monocenter experience with 1006 consecutive examinations

A Prospective Multicenter Blinded Cohort Study Comparing Diagnostic Yield of Capsule Endoscopy (CE) Prior to Ileocolonoscopy (IC) Compared to Small Bowel Follow Through (SBFT) Prior to IC in Patients With Suspected Crohn's Disease (CD)

A Prospective Multicenter Blinded Cohort Study Comparing Diagnostic Yield of Capsule Endoscopy (CE) Prior to Ileocolonoscopy (IC) Compared to Small Bowel Follow Through (SBFT) Prior to IC in Patients With Suspected Crohn's Disease (CD)

A New and Improved Version of a Novel Algorithm of Automatic Lesion Detection and Its Impact on the Diagnostic Yield of Capsule Endoscopy in Patients With Small Bowel Gastrointestinal Bleeding

A New and Improved Version of a Novel Algorithm of Automatic Lesion Detection and Its Impact on the Diagnostic Yield of Capsule Endoscopy in Patients With Small Bowel Gastrointestinal Bleeding

PWE-035 Diagnostic yield of capsule endoscopy in small bowel Crohn's disease: an experience from a district general hospital

Introduction The small bowel is a common site for Crohn9s disease but remains relatively inaccessible endoscopically for the majority of its part. There has been variable success in diagnosing active Crohn9s disease by conventional radiological imaging methods.1 The British Society of Gastroenterology (BSG) guidelines on small bowel capsule endoscopy (CE) recommend that CE should be considered in patients with a high suspicion of small bowel Crohn9s disease undetected by conventional means.2 Methods We carried out a retrospective audit of all patients referred for CE in our hospital between 2005 and 2009 with suspected small bowel Crohn9s disease undetected by conventional means to evaluate the diagnostic yield of CE and its impact on management. Results Small bowel Crohn9s disease was suspected in patients with symptoms of abdominal pain or diarrhoea and weight loss, positive family history of inflammatory bowel disease, extra-intestinal manifestations or investigational findings including iron deficiency anaemia (IDA), raised CRP/ESR or hypoalbuminaemia. All patients presenting with symptoms of abdominal pain had small bowel radiology before proceeding to CE in line with BSG guidelines.4 202 patients underwent CE during the study period of which 34 (16.8%) patients were referred to exclude small bowel Crohn9s disease. 19 (56%) patients were females. A diagnosis of Crohn9s disease was made in 13 (38%) patients on CE based on the findings of erosions, aphthous ulcers etc. 13 (38%) patients had a normal examination, 2 (6%) had NSAID induced ulcers, 1 (3%) was diagnosed with coeliac disease, 1 (3%) had erosive gastropathy, 2 (6%) had discrete aphthous ulcers of query significance and 2 (6%) had limited views due to poor bowel preparation for which a repeat CE examination was requested. CE changed management in 19 (56%) patients and included the following – 12 patients with Crohn9s disease were managed conservatively while one had surgery, NSAIDs were stopped in two, proton pump inhibitor was started in one, gluten free diet was initiated in one and two patients underwent repeat endoscopic examination which excluded Crohn9s disease. Conclusion In our selected cohort, small bowel Crohn9s disease was diagnosed in 38% of patients that was undetectable by conventional means. This figure is slightly lower than that mentioned in the literature (43–71%).3 Other significant diagnoses were obtained in 12% of cases (NSAID induced ulcers, coeliac disease and erosive gastropathy) and were managed conservatively with good outcome.

The role of endoscopy in the management of patients with diarrhea

The role of endoscopy in the management of patients with diarrhea

Diagnostic yield of capsule endoscopy in elderly patients with obscure GI bleeding

Diagnostic yield of capsule endoscopy in elderly patients with obscure GI bleeding

W1304 Are Patients with Chronic Iron-Deficiency Anaemia Different from Those with Occult Gastrointestinal Bleeding? Clinical Characteristics and Diagnostic Yield of Capsule Endoscopy

W1304 Are Patients with Chronic Iron-Deficiency Anaemia Different from Those with Occult Gastrointestinal Bleeding? Clinical Characteristics and Diagnostic Yield of Capsule Endoscopy

Meta-Analysis of the Yield of Capsule Endoscopy in Patients with Crohn's Disease

Meta-Analysis of the Yield of Capsule Endoscopy in Patients with Crohn's Disease

Capsule Endoscopy: Ways to Avoid Missing Lesions and to Optimize Diagnostic Yield

Capsule endoscopy allows complete endoscopy of the small intestine, and its diagnostic yield can be increased with proper patient selection and preparation for the procedure. The use of prokinetic medications and bowel-cleansing solutions may be beneficial, but further studies are needed. Simethicone may decrease bubbles in the small intestine. Incomplete studies warrant further evaluation with complementary radiology studies, such as computed tomography enterography or magnetic resonance enterography, double-balloon enteroscopy, or a repeat capsule endoscopy. Patients with delayed gastric emptying should be considered for a repeat capsule endoscopy with the capsule being placed in the duodenum at the time of an upper gastrointestinal endoscopic examination. The yield of capsule endoscopy may be increased by spending more time examining the proximal small bowel and by utilizing the suspected blood indicator.