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PubMed2006

Capsule endoscopy in the pediatric patient.

Wireless capsule endoscopy represents an extraordinary technical innovation in diagnostic gastrointestinal endoscopy. As in adult patients, it opens new horizons that permit an accurate and noninvasive approach to identifying occult lesions in the small bowel in children and adolescents. A limitation in the pediatric age group is the size of the capsule, precluding its use in infants and small toddlers. In children unable to swallow the capsule, "front loading" the gastroscope to introduce it into the duodenum is a suitable alternative approach. Capsule endoscopy is highly useful to evaluate for inflammatory changes in patients suspected to have small bowel Crohn's disease in whom conventional imaging failed to confirm the diagnosis. It is now the method of first choice to assess for small bowel polyps or tumors, to find a source of blood loss in obscure intestinal bleeding, and for undiagnosed malabsorptive conditions such as intestinal lymphangiectasia. Capsule retention is the one major potential adverse effect of capsule endoscopy. In patients suspected to have a small bowel stenosis, consideration should be given to using the patency capsule prior to using the real videocapsule so as to decrease the risk of capsule retention.

Journal Article↗
PubMed2006

Clinical application of wireless capsule endoscopy in pediatric patients for suspected small bowel diseases.

Capsule endoscopy (CE) has been demonstrated to be safe and well tolerated in adults with suspicion of small intestinal diseases with negative results of gastroscopy and colonoscopy. However, its value in pediatric patients has not yet been well studied. This study aimed to evaluate the results and safety of CE in pediatric patients with suspicion of small bowel disorders. There were 16 consecutive children and adolescents (12 boys, 4 girls) and 15 adults (9 men, 6 women) referred to us for suspected small bowel diseases from August 2002 to September 2005. Among the pediatrics, six patients were less than 10 years old. Technique for capsule placement, gastric transit time, small bowel transit time, excretion time of capsule endoscopy, capsule findings, and complications were recorded. All 16 pediatric patients described that the capsule was easy to swallow except for three children. Finally we delivered the capsule under gastroscopy with overtube for these three children. No capsule retention occurred during our study. Median recording time was 7 h 44 min (range 6 h 51 min-9 h 11 min). Median gastric transit time was 83.5 min (range 4-296 min). Median small bowel transit time was 270 min (range 142-484 min). Median excretion time of capsule was 33.9 h (range 12-96 h). There was no significant difference in excretion time of capsule, gastric transit time and small bowel transit time between pediatric patients and adult patients (P > 0.05). CE was positive in 12 patients, including Crohn's disease (4), hemangioma (2), angiodysplasia (2), Meckel diverticulum (1), polyp (1), aphthous ulcer in ascending colon (1), and cobblestone appearance of ileal mucosa. CE has been performed safely in a small series of pediatric patients after ingestion or endoscopic placement of the capsule. The high yield of abnormal findings was comparable to those of adult patients.

Adolescent↗
PubMed2006

Outcome of capsule endoscopy in determining indication and route for push-and-pull enteroscopy.

BACKGROUND AND STUDY AIM: Video capsule endoscopy and push-and-pull enteroscopy (PPE), both allow a complete examination of the small bowel in patients with suspected intestinal disorders. Due to the invasiveness of PPE, indications should probably be selective. The aim of the present prospective study was to evaluate the outcome of an approach whereby capsule endoscopy was used to select patients in whom PPE was indicated. PATIENTS AND METHODS: 164 patients were included (90 men; age 54+/-18 years) with various indications for small-bowel investigation, such as obscure bleeding (n=88), suspected Crohn's (n=14) or celiac (n=12) disease, or known or strongly suspected localized diseases such as neoplasms (n = 18) for biopsy. Four patients with a suspected intestinal stenosis underwent PPE without prior capsule endoscopy. In the remaining 160 patients, who had a capsule endoscopy, PPE was selected if there were lesions requiring biopsy or angiodysplasias to be treated by argon plasma coagulation (APC). Regarding the insertion route, an anal PPE was indicated if the capsule transit time from ingestion to arrival at the lesion was >or= 75 % of the total time from ingestion to arrival at the cecum. After gut cleansing, PPE was performed with general anesthesia, and the small bowel was examined until the lesion was reached or the scope could not be advanced further. If the suspected lesion had not been reached, a second procedure was performed through the alternative route, under the same conditions. RESULTS: The diagnostic yield of capsule endoscopy was 75 %. According to the indications, 47 PPE procedures were performed in 42 patients, including 33 through the oral route, 4 through the anal route and 5 combined ones. Indications were: suspicion of intestinal tumor (n=13), celiac disease with chronic bleeding (n=4), suspicion of Crohn's disease (n=3), treatment of significant arteriovenous malformations (AVMs) (n=10), diffuse enteropathies (n=3), nonsteroidal anti-inflammatory drug (NSAID)-related conditions (n=2), and obscure digestive bleeding (n=3). Lesions detected by capsule endoscopy were reached by PPE in all but two cases. The positive predictive value (PPV) of capsule endoscopy to make a correct indication for PPE was 94.7 % and the negative predictive value (NPV) was 98.3 %. The PPV and NPV of a time index of > 0.75 to start via the anal route were 94.7 % and 96.7 %. No complications were observed and all patients were discharged the day after the procedure. Follow-up at 9 months showed that capsule endoscopy followed by PPE had positively influenced the management of 90.5 % of the patients. CONCLUSIONS: The use of capsule endoscopy as a filter for PPE results in effective management of patients with various intestinal diseases. Capsule endoscopy can also direct the choice of route of PPE; a time index of > 0.75 appears to reliably indicate an anal route so that a double procedure is required in only about 12 % of cases.

Adult↗
PubMed2004

Can clinical features predict the likelihood of finding abnormalities when using capsule endoscopy in patients with GI bleeding of obscure origin?

BACKGROUND: Capsule endoscopy is becoming the investigation of choice for GI bleeding of obscure etiology. This study examined whether clinical or other features predict an increased likelihood of finding a lesion in patients with this type of bleeding. METHODS: Clinical and other data were collected prospectively for 92 patients undergoing capsule endoscopy for GI bleeding of obscure origin. Patients were divided into two groups: those with overt bleeding (42 patients) and those with anemia alone (50 patients). The relationship between these data and the findings at capsule endoscopy was examined. RESULTS: A definite or probable cause of bleeding was found in 60 patients (angiodysplasias 47, tumor 7, ulcer 3, gastric antral vascular ectasia 2). There was no difference between the two groups with respect to age, gender, mode of presentation, duration of bleeding, or need for transfusion. Lesions were found as often in patients who had only one preceding endoscopy and colonoscopy as in those who had multiple procedures. Colonic cleansing and cecal imaging by the capsule did not influence the result. Hospitalized patients were more likely to have an actively bleeding lesion detected. CONCLUSIONS: Capsule endoscopy is equally useful in patients with overt and occult GI bleeding of obscure origin. Capsule endoscopy should be performed early in the evaluation of these patients.

Adolescent↗
PubMed2005

Feasibility and safety of string, wireless capsule endoscopy in the diagnosis of Barrett's esophagus.

BACKGROUND: Capsule endoscopy is a major technological advancement in the visualization of the small bowell. Its utility in the evaluation of the esophagus is mainly limited by its rapid and unpredictable transmission, thus limiting the number of pictures of the esophagus, in particular, the distal esophagus. METHODS: Strings were attached to the wireless capsule endoscopy device to allow its controlled movement up and down the esophagus. Microbiologic cultures of the capsule's surface after high-level disinfection were carried out after the procedure. At the time of recording, discomfort associated with the procedure was documented. Patient preference compared with conventional EGD was recorded. An independent endoscopist blinded to the EGD diagnoses assessed the diagnostic accuracy of pictures obtained. OBSERVATIONS: Fifty patients with Barrett's esophagus were enrolled: 28 with short-segment Barrett's and 22 with long-segment Barrett's. The procedure was safe (no strings were disrupted, and no capsule was lost), and it rendered negative microbiologic cultures after high-level disinfection. The mean recording time was 7.9 minutes; all patients with both short- and long-segment Barrett's esophagus were successfully identified. The difficulty/discomfort associated with swallowing the device, throat discomfort, gagging, moving the capsule (up and down and upon retrieval of the capsule) was none or minimal in 74%, 98%, 96%, 94%, and 76%, respectively. A single capsule was used in 24 studies, and the majority of patients (92%) preferred string-capsule endoscopy to EGD. CONCLUSIONS: String-capsule endoscopy was feasible, safe, and highly acceptable, and was preferred by patients and may prove to be more cost effective than screening EGD.

Adult↗
PubMed2004

Capsule endoscopy is safe and effective after small-bowel resection.

BACKGROUND: Because capsule endoscopy is a relatively new technique, the indications, the contraindications, and the complications of the procedure have not been fully delineated. The present study was undertaken to determine the utility and the safety of capsule endoscopy in patients who have undergone small-bowel resection. METHODS: Ten patients (mean age 48.5 [8.4] years) were included in the study. Eight had undergone surgical resection for Crohn's disease and two for malignancy. Indications for capsule endoscopy included suspected relapse of Crohn's disease or of malignancy, with a negative conventional evaluation that included barium contrast radiography, upper endoscopy, colonoscopy, US, CT, and push enteroscopy. Capsule endoscopy was performed in the standard fashion. OBSERVATIONS: No side effects were observed in any patient. Natural excretion of the capsule was reported at a mean of 72 hours. In 7 patients (70%), capsule endoscopy revealed recurrence of disease in the small bowel: one recurrent malignancy, 6 recurrent Crohn's disease. The information gained was helpful with respect to further treatment for all of these patients. CONCLUSIONS: Capsule endoscopy is safe and effective in the evaluation of patients who have undergone surgical resection of the small bowel for benign or malignant disease.

Crohn Disease↗
PubMedDate not supplied

[Video-capsule endoscopy for small bowel investigation].

Capsule endoscopy is a new technique of exploration which enables to visualize the entire small bowel. Occult or unexplained digestive bleeding currently constitutes on major indication of this technique. The aim of this study is to report the results obtained among 15 patients investigated by capsule endoscopy and to discuss the place of this new technique in the small bowel exploration.

Adolescent↗
PubMed2006

[Clinical value of capsule endoscopy in obscure gastrointestinal bleeding].

OBJECTIVE: To investigate clinical diagnostic value of capsule endoscopy in obscure gastrointestinal bleeding. METHODS: Capsule endoscopy were performed in 90 patients with obscure gastrointestinal bleeding, which was defined as negative finding by gastroscopy and colonoscopy in our hospital. RESULT: 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). CONCLUSION: 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.

Adolescent↗
PubMed2006

Video capsule endoscopy in small-bowel malignancy: a multicenter Belgian study.

BACKGROUND AND STUDY AIMS: Early diagnosis of small-bowel tumors is crucial for therapy. Video capsule endoscopy has improved the diagnosis of small-bowel diseases, but data concerning the role of this technique in detecting small-bowel malignancy are scarce. The aim of this paper was to review all capsule endoscopy findings at Belgian hospitals, in order to evaluate the diagnostic yield of capsule endoscopy in the field of small-bowel malignancy. PATIENTS AND METHODS: For this retrospective study, the seven Belgian academic hospitals where the device was being used were asked to review the findings obtained by means of video capsule endoscopy, and to collect information about the cases of small-bowel malignancy. RESULTS: In total, 443 capsule endoscopies were performed up to November 2004, and 11 malignant small-bowel processes were detected (2.5%). The most frequent indications for performing capsule endoscopy in those 11 cases were intestinal bleeding of undefined origin or iron-deficiency anemia. The mean number of diagnostic procedures performed before capsule endoscopy was 3.6. The capsule endoscopy results had a diagnostic yield of 1.6% after classical work-up. In 55% of these cases, capsule endoscopy findings had an influence on therapy. CONCLUSIONS: Tumors of the small bowel remain a rare condition. Video capsule endoscopy is able to detect tumors undiagnosed by classical procedures in about 1.6% of cases and has an impact on the therapy in 55% of the tumor cases.

Aged↗
PubMed2004

Result of wireless capsule endoscopy in patients with suspected small bowel disease: the first series from Thailand.

BACKGROUND AND AIMS: Capsule endoscopy (CE) is a promising diagnostic tool for patients with obscure gastrointestinal bleeding. Only a few papers have reported data from Asian countries. This retrospective study aimed to demonstrate result of capsule endoscopy in patients with suspected small bowel disease as the first series from Thailand. METHOD: Twenty-one patients who underwent wireless capsule endoscopy between July 2003 and June 2004 at King Chulalongkorn Memorial Hospital were retrospectively reviewed in the present study. The indications for capsule endoscopy were overt obscure gastro-intestinal bleeding (n= 12), occult obscure gastro-intestinal bleeding (n=5), chronic recurrent abdominal pain (n=3) and chronic diarrhea (n=1). Diagnoses according to findings of capsule endoscopy were classifield into definite, suspicious and negative finding. RESULTS: The mean age of the 21 patients (10 men and 11 women) was 46 (standard deviation, 18.57) years. Of those 17 obscure gastrointestinal bleeding patients, there were positive findings in 11 from 17 patients (65%). Four patients (24%), 3 with tumor and another with AVM, were classified as definite results. Seven patients (41%), 6 with angioectasia and another with a small ulcer, were classified as suspicious because there was no demonstrated active bleeding lesion and no other clinical supportive evidence. Of these 3 patients with recurrent abdominal pain, one patient (33%) with terminal ileum lymphoid hyperplasia was classified as definite result because of clinical improvement after treatment of the lesion. Another case of chronic diarrhea yielded a negative result. CONCLUSION: Wireless capsule endoscopy is a safe and useful mode of investigation for the diagnosis of obscure gastrointestinal bleeding in Thailand. There is not so much difference in capsule endoscopy results between Western and Asian series.

Abdominal Pain↗
PubMed2006

Does capsule endoscopy recognise gastric antral vascular ectasia more frequently than conventional endoscopy?

BACKGROUND: Gastric antral vascular ectasia (GAVE) is a rare cause of obscure gastrointestinal bleeding which can be difficult to recognise endoscopically. Capsule endoscopy is primarily designed to image the small bowel, but may identify gastric and colonic lesions. There have been few reported cases of GAVE diagnosed by capsule endoscopy in the literature. OBJECTIVE: Our aim was to assess the frequency of GAVE in patients with obscure gastrointestinal bleeding referred for capsule endoscopy. DESIGN: Case series. SETTING: This study was conducted in a tertiary referral hospital. PATIENTS. This study comprised 128 consecutive patients with obscure gastrointestinal bleeding. INTERVENTIONS: All patients underwent capsule endoscopy. RESULTS. Six patients were diagnosed with GAVE on the basis of the capsule endoscopy findings (4.7%, five female, median age 71.5 years). All patients had previously had numerous gastrointestinal investigations prior to capsule endoscopy. Five patients to date have been treated with argon plasma coagulation of their vascular lesions. This has resulted in stabilisation of their haemoglobin and cessation of blood transfusions in 4/5 cases with an average follow up period of 15 months. CONCLUSIONS: GAVE is commonly missed at gastroscopy and accounted for 4.7% of patients referred for capsule endoscopy with obscure gastrointestinal bleeding (in our series). This case series represents the largest number of GAVE recognised by capsule endoscopy. In the presence of any of the reported risk/associated factors for GAVE the gastroenterologist interpreting the capsule images should have a high index of suspicion.

Aged↗
PubMedDate not supplied

Capsule endoscopy--a new frontier.

Capsule endoscopy (CE)--about the size of a vitamin pill--has enormous potential for the noninvasive investigation of diseases of the small bowel--"the last frontier" of endoscopy. Its use is spreading rapidly-over 150,000 capsules have been ingested worldwide since CE was introduced in 2001--reflecting the enormous impact of CE on the field of gastroenterology. CE has a higher diagnostic yield in recognizing Crohn's disease than any other method available. CE is able to establish a diagnosis in a high proportion of patients with obscure gastrointestinal bleeding, detecting small bowel lesions. New indications and applications of CE are emerging: CE has proven useful in the diagnosis of celiac disease, NSAID enteropathy and small bowel malignancies, its use in pediatric gastroenterology, the new Pill Cam ESO specifically-designed to visualize the esophageal mucosa etc. The objectives of this article are to present an overview of the CE: its history and development, indications, contraindications, and CE role in the diagnosis of small bowel diseases. Finally, it is presented the experience with CE at our institutions.

Contraindications↗
PubMed2006

Esophageal capsule endoscopy in patients refusing conventional endoscopy for the study of suspected esophageal pathology.

AIM: Esophageal capsule endoscopy is a well tolerated procedure that does not require sedation and has proved its value for the study of the esophagus. The aim of our study was to assess the feasibility, accuracy, safety and acceptability of esophageal capsule endoscopy for the study of gastroesophageal reflux disease and esophageal varices in patients who refused conventional upper gastrointestinal endoscopy. PATIENTS AND METHODS: Thirty consecutive examinations performed in 28 patients (15 men/13 women; mean age: 58.5+/-12.4 years; range: 23-87 years) were reviewed. Twenty-five examinations were performed in 23 patients presenting with chronic gastroesophageal reflux disease symptoms and the remaining five were carried out in patients with cirrhosis for screening of esophageal varices. The procedures were done with the new PillCam ESO that harbors two viewing cupules and takes a total of 14 frames/s. Technical data (total recording time, esophageal transit time and Z-line visualization), clinical findings (Savary-Miller grade; presence and characteristics of esophageal varices or portal hypertension gastropathy), and patient's opinion (quality and comfort questionnaire) were analyzed. RESULTS: All the patients ingested and excreted the capsule without complications. Two examinations in the gastroesophageal reflux disease group were repeated; one was issued as a follow-up and the other because no images were recorded in the first capsule endoscopy. From the former, only the satisfaction questionnaire was analyzed. Mean total recording time and esophageal transit time were 1224 and 243.79 s, respectively (range: 2-1192 s). Complete study of the Z-line was possible in 23 examinations (23/29; 79.3%). Esophageal erosions were seen in 58.33% (14/24) of the examinations carried out in patients with gastroesophageal reflux disease. Nine out of 14 patients (64.29%) presented with grade I esophagitis and the other five (35.71%) with grade II esophagitis. Among the five patients with cirrhosis, small varices were visualized in one (1/5; 20%), while large varices with red spots were evidenced in the remaining three (3/5; 60%). All four patients showing esophageal varices were found to have portal hypertension gastropathy. In most examinations, patients found the capsule easy to swallow (28/30; 93.33%), asymptomatic (29/30; 96.66%), evaluated the procedure as comfortable (29/30; 96.66%), and would repeat it if necessary (30/30; 100%). CONCLUSIONS: Esophageal capsule endoscopy is an adequate alternative diagnostic method for the study of gastroesophageal reflux disease and for the screening of esophageal varices in patients refusing to undergo conventional upper gastrointestinal endoscopy.

Adult↗
PubMed2005

Effects of capsule endoscopy on cardiac pacemakers.

BACKGROUND AND STUDY AIMS: Capsule endoscopy is a new, noninvasive diagnostic technique which enables visualization of the mucosa of the small intestine in physiological conditions and without the need to subject the patient to external radiation. Wireless capsule video endoscopy is contraindicated in patients with a cardiac pacemaker. However, on the basis of the characteristics of the radiofrequency band used by the endoscopic capsule, together with a series of other factors, it is possible that the patient's use of a pacemaker should not be a contraindication to capsule endoscopy. PATIENTS AND METHODS: This work had two phases: an in vitro study, using an interference detector, and an in vivo study involving 20 patients with cardiac pacemakers who showed symptoms or signs that justified a capsule endoscopy investigation. RESULTS: No interference was observed during the first, in vitro, phase of the study. In the second phase, patients wore a Holter recorder for a mean time of 10 hours, during which the average number of recorded QRS complexes exceeded 30,000. All the pacemakers functioned normally. Interference due only to myopotentials was detected in a single patient in whom modification of the pacemaker programming was necessary. In the other 19 patients, neither sensing nor stimulation failures were observed. CONCLUSIONS: No interference between the pacemaker and the endoscopic capsule was observed. All the pacemakers functioned normally, and no increased incidence of adverse effects was observed. Neither was any pacemaker-induced interference observed on the capsule endoscopy images.

Aged↗
PubMed2006

Capsule endoscopy: an alternative to duodenal biopsy for the recognition of villous atrophy in coeliac disease?

BACKGROUND: Villous atrophy present on a duodenal biopsy remains the 'gold standard' diagnostic test for coeliac disease. However, endoscopic biopsy may cause morbidity and discomfort. Our aim was to evaluate wireless capsule endoscopy as an alternative test for the recognition of villous atrophy. METHOD: Twenty-one patients with a positive endomysial antibody referred for endoscopy and duodenal biopsy were also offered a wireless capsule endoscopy to evaluate their small bowel. Concurrently, other patients (n=23) referred for a wireless capsule endoscopy acted as controls. Wireless capsule endoscopy reports were assessed for the presence of villous atrophy by one blinded investigator. RESULTS: Twenty endomysial antibody positive patients subsequently had villous atrophy on duodenal biopsy. The controls all had normal duodenal biopsies (with a negative endomysial antibody) and no evidence of villous atrophy noted on their wireless capsule endoscopy. Of the 20 endomysial antibody positive patients with confirmed villous atrophy on biopsy, 17 had villous atrophy also detected by wireless capsule endoscopy. The sensitivity, specificity, positive and negative predictive values for wireless capsule endoscopy recognising villous atrophy were 85%, 100%, 100%, 88.9%, respectively. CONCLUSION: Wireless capsule endoscopy may be an option to recognise villous atrophy in patients with a positive endomysial antibody who are unwilling, or unable to have a gastroscopy. However, a negative test should be followed by a biopsy if coeliac disease is to be excluded.

Adult↗
PubMed2004

Wireless capsule endoscopy in Chinese patients with suspected small bowel diseases.

OBJECTIVE: To evaluate the use of wireless capsule endoscopy in Chinese patients. DESIGN: Retrospective analysis. SETTING: University teaching hospital, Hong Kong. PATIENTS: Twenty-eight patients who had undergone wireless capsule endoscopy between December 2002 and December 2003. MAIN OUTCOME MEASURES: Diagnoses according to findings of capsule endoscopy and complications from the procedure. RESULTS: The mean age of the 28 patients (15 men and 13 women) was 60.0 (standard deviation, 18.3) years. The indications for capsule endoscopy were obscure gastro-intestinal bleeding (n=16), unexplained iron-deficiency anaemia (n=9), and recurrent abdominal pain (n=3). Half of the patients had abnormal endoscopy findings that may account for their presenting symptoms. The most common abnormality was angioectasia of the small bowel. Small bowel ulcers and erosions were also noted in three patients with obscure bleeding. In contrast, none of the patients with recurrent abdominal pain had abnormal capsule endoscopy. No complications arose from the procedure. CONCLUSIONS: Wireless capsule endoscopy is a safe and useful mode of investigation for the diagnosis of obscure gastro-intestinal bleeding in Chinese patients.

Abdominal Pain↗
PubMed2006

Video capsule endoscopy in peutz-jeghers syndrome: a blinded comparison with barium follow-through for detection of small-bowel polyps.

BACKGROUND AND STUDY AIMS: Video capsule endoscopy has shown promise for the surveillance of significant small-bowel polyps in patients with Peutz-Jeghers syndrome. In this study the yield of significant small-bowel polyps by capsule endoscopy was compared to the yield of these polyps by barium follow-through in adults with Peutz-Jeghers syndrome. PATIENTS AND METHODS: A total of 19 adults with Peutz-Jeghers syndrome who were undergoing surveillance underwent both capsule endoscopy and barium follow-through examinations, and the number of small-bowel polyps of at least 1 cm in diameter that were detected was recorded for each method. The two methods were assessed in terms of comfort and convenience for the patients and their preferred future surveillance method, using a questionnaire. RESULTS: Capsule endoscopy detected a median of four significant small-bowel polyps while barium follow-through detected a median of one (P = 0.008). There was a trend towards more participants having at least one significant small-bowel polyp detected by capsule endoscopy than was the case with barium follow-through, though capsule endoscopy seemed to be less reliable for accurate sizing of polyps that were at the limit of clinical significance. Most participants expressed a preference for capsule endoscopy for future surveillance. CONCLUSIONS: Capsule endoscopy should replace barium follow-through for the surveillance of small-bowel polyps in adults with Peutz-Jeghers syndrome, but the findings of this study should be interpreted with caution until a more reliable means of sizing polyps by capsule endoscopy is available.

Administration, Oral↗
PubMed2005

[Wireless capsule endoscopy and its role in gastroenterology: our results and a review of the literature].

INTRODUCTION: Since its recent introduction, capsule endoscopy has revolutionized the diagnostics of diseases of the small bowel. The number of studies on the use of this method is constantly increasing. Along with this, our knowledge about the usability and diagnostic power of capsule endoscopy is growing and the indications for this technique are getting progressively more accurate. AIMS: To study the usability of capsule endoscopy in suspected Crohn's disease, in gastrointestinal bleeding of small bowel origin, and in undetermined abdominal complains. METHOD: Capsule endoscopy was performed in 20, previously examined, carefully selected patients. RESULTS: Positive findings were recorded in all patients with gastrointestinal bleeding and in 3/4 of patients with suspected Crohn's disease. However, in patients with indeterminate abdominal complains, the capsule endoscopy proved to be inefficient. CONCLUSION: In the study below, based on their own experience, the authors try to provide an overall picture of capsule endoscopy by reviewing contemporary medical literature. The usability of the capsule endoscopy in suspected Crohn's disease and gastrointestinal bleeding of small bowel origin is suggested by the results of the study.

Adolescent↗