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Eitan Scapa

Publications and source records attributed to Eitan Scapa.

4 recordsLinked to original sources

First histologic confirmation of the diagnosis made by the new wireless-capsule endoscopy.

Wireless-capsule endoscopy is a new painless technique for endoscopic imaging of the small bowel. A 63-year-old male with iron deficiency anemia and thrombocytosis and extensive negative workup was examined twice with the capsule and was found to have multiple bluish polypoid lesions with a villous-appearing texture. Some of these lesions actually were seen to be bleeding. This is the first time that we have obtained histologic evidence for lesions seen only on the video-capsule endoscopy. The lesion was reached by deep ileoscopy via colonoscopy. On histologic analysis, there was acute and chronic ileitis.

Capsules↗

Initial experience of wireless-capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology.

OBJECTIVE: Small bowel pathology can be diagnosed using enteroscopy (which has limitations) and by x-ray (which is not sensitive for flat lesions). For the first time ever, we used a new technique, wireless-capsule video endoscopy, to diagnose small bowel pathology. Our aim was to prove the effectiveness and safety of this technology. METHODS: We used the Given (M2A) system in 35 patients, aged 18-80 yr, who suffered from unexplained GI bleeding or in whom there was a clinical suspicion of small bowel disease. All patients had a small bowel x-ray. Patients with suspected narrowing of the bowel or a clinical suspicion of intestinal obstruction, or with a history of major abdominal surgery, were excluded from the study. No pregnant women or patients with diabetes mellitus were included. RESULTS: Abnormal findings were found in 29 of 35 (82.9%) patients. Twenty-two of 29 (75.9%) patients had significant pathological findings explaining their clinical situation. Diagnostic yield was therefore 62.9% (22 of 35 patients). Among the various findings, the capsule detected ulcers, erosions, angiodysplasia, and submucosal lesions. The source of bleeding was found in 15 of 20 patients with iron deficiency anemia. There were no immediate significant side effects and none reported up to 1 month after ingestion of the capsule. The capsule was evacuated by all patients. CONCLUSIONS: The wireless-capsule video endoscope, in our study of feasibility, was proven to be a safe, painless, ambulatory, and effective procedure, with a high diagnostic yield. Its major importance is in diagnosing small bowel pathology where all other imaging techniques have failed.

Adult↗

Non-traumatic perforation of the small intestine. Report of 13 cases and review of the literature.

BACKGROUND/AIMS: Non-traumatic perforation of the small intestine (NTPSI) is a rare entity. It is possible that nowadays, the etiology of NTPSI has changed and that mortality might be lower. The aim of this study was to compare a recent series with previous series published in the literature. METHODOLOGY: During 13 years (1984-1996), 13 patients were diagnosed by laparotomy and histology as cases of NTPSI. RESULTS: The various etiologies of the perforations were: Crohn's disease in 6 (46%) patients, an ingested foreign body in 3 (23%) patients, primary intestinal malignancies (B-cell high-grade lymphoma and leiomyosarcoma) in 2, an internal hernia and an unclear etiology ("idiopathic") in 1 patient each. The symptoms were non-specific and an abdominal X-ray showed free-air in only 1 of 11 patients. Only one patient died postoperatively. CONCLUSIONS: NTPSI remains a rare entity with an incidence of 1 case/year/350,000 population. Compared to seven previous series from industrialized countries, it seems that Crohn's disease has recently become the major etiology for NTPSI, probably due to the increasing prevalence of this disease. It is possible that many of the frequent "idiopathic" cases diagnosed in the past were due to non-steroidal anti-inflammatory drugs. While in developing countries, typhoid fever remains a major cause of NTPSI, opportunistic infections are recently reported in industrialized countries. The diagnosis of NTPSI is usually made at laparotomy. In most cases, resection and primary anastomosis is appropriate. Mortality rates might be lower than in the past.

Adult↗