scholarly journals Increased diagnostic yield of small bowel tumors with capsule endoscopy

Cancer ◽  
2006 ◽  
Vol 107 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Gena M. Cobrin ◽  
Robert H. Pittman ◽  
Blair S. Lewis
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Small Bowel Tumors

scholarly journals Assessment of the Role of a Second Evaluation of Capsule Endoscopy Recordings to Improve Diagnostic Yield and Patient Management

2021 ◽  
pp. 1-5
Author(s):  
Gerardo Blanco-Velasco ◽  
Rolando Pinho ◽  
Omar Michel Solórzano-Pineda ◽  
Claudia Martínez-Camacho ◽  
Luis Fernando García-Contreras ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Patient Management ◽  
Interobserver Agreement ◽  
Diagnostic Yield ◽  
Vascular Lesions ◽  
Deficiency Anemia ◽  
Small Bowel Tumors ◽  
Significant Pathology

<b><i>Introduction:</i></b> The diagnostic yield (DY) of small-bowel capsule endoscopy (SBCE) varies considerably according to its indication. Some strategies have been used to increase DY with varying results. The intention of this study was to identify whether evaluation of the SBCE recordings by a second reviewer can increase DY and change patient management. <b><i>Methods:</i></b> One hundred SBCEs with different indications, already read by an endoscopist were read by a second blinded endoscopist. When the results of the 2 readings were different, the images were discussed by the endoscopists; if no consensus was reached, they took the opinion of a third endoscopist into account. All the participating endoscopists had experience in reading SBCEs (i.e., &#x3e;50 per year). The SBCE findings were divided into positive (vascular lesions, ulcers, and tumors), equivocal (erosions or red spots), and negative. The interobserver agreement and the increase in DY were assessed as well as the percentage of false-negatives (FNs) in the first evaluation. <b><i>Results:</i></b> The indications for SBCE were small-bowel bleeding (SBB) in 48 cases, Crohn’s disease (CD) in 30, and other causes (iron-deficiency anemia, small-bowel tumors, and diarrhea) in 22. There was substantial interobserver agreement between evaluations (κ = 0.79). The findings in the first evaluation were positive in 60%, equivocal in 20% and, negative in 20%. In the second evaluation, 66% were positive, 18% were equivocal, and 16% were negative. The increase in DY with the second reading was 6% (<i>p</i> = 0.380), i.e., 6.3% for SBB, 4.4% for CD and 9.2% for other indications, resulting in a change in management of 4% of the patients. FNs in the first SBCE reading were found in 4% of the SBCEs. <b><i>Discussion:</i></b> A second evaluation of the SBCE recordings identified significant pathology that the first evaluation had missed, resulting in a nonsignificant 6% increase in DY and a change in the management of 4% of the patients.

scholarly journals Current Clinical Indications for Small Bowel Capsule Endoscopy

2015 ◽  
Vol 28 (5) ◽  
pp. 632 ◽  
Author(s):  
Bruno Rosa ◽  
José Cotter
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Gastrointestinal Bleeding ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Diagnostic Instrument ◽  
Obscure Gastrointestinal Bleeding ◽  
Disease Extent ◽  
Small Bowel Tumors

<p><strong>Introduction:</strong> Small bowel capsule endoscopy is currently the first line diagnostic examination for many diseases affecting the small bowel. This article aims to review and critically address the current indications of small bowel capsule endoscopy in clinical practice.<br /><strong>Material and Methods:</strong> Bibliographic review of relevant and recent papers indexed in PubMed.<br /><strong>Results and Discussion:</strong> Small bowel capsule endoscopy enables a non-invasive full-assessment of the small bowel mucosa, with high diagnostic yield even for subtle lesions. In patients with obscure gastrointestinal bleeding, diagnostic yield is higher when performed early after the onset of bleeding. Endoscopic treatment of angioectasias using balloon-assisted enteroscopy may contribute to reduce rebleeding, while the risk of rebleeding in patients with “negative“ small bowel capsule endoscopy is debatable. Cross-sectional imaging<br />may be more accurate than small bowel capsule endoscopy for the diagnosis of large small bowel tumors. The Smooth Protruding Index on Capsule Endoscopy (SPICE score) may help to differentiate submucosal tumors from innocent bulges. Small bowel capsule endoscopy is also a key diagnostic instrument in patients with suspected Crohn’s disease and non-diagnostic ileocolonoscopy; it may also influence prognosis and therapeutic management, by determining disease extent and activity in patients with known Crohn’s disease. The role of small bowel capsule endoscopy to investigate possible complications in patients with non-responsive coeliac<br />disease is evolving.<br /><strong>Conclusions:</strong> Small bowel capsule endoscopy is a valuable diagnostic instrument for patients with obscure gastrointestinal bleeding and/or suspected small bowel tumors; it may also be a key examination in patients with suspected Crohn’s disease, or patients with known Crohn’s disease to fully assess disease extension and activity; finally, it may contribute for the diagnosis of complications of non-responsive coeliac disease.</p>

ID: 3519521 FEASIBILITY AND DIAGNOSTIC YIELD OF SMALL BOWEL CAPSULE ENDOSCOPY IN PATIENTS WITH SURGICALLY ALTERED GASTRIC ANATOMY

2021 ◽  
Vol 93 (6) ◽  
pp. AB354
Author(s):  
Xavier Dray ◽  
Maria Elena Riccioni ◽  
Gabriele W. Johansson ◽  
Martin Keuchel ◽  
Guillaume Perrod ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Diagnostic Yield

Rendimiento diagnóstico de la videocápsula endoscópica en el sangrado del intestino delgado manifiesto

2020 ◽  
Vol 50 (4) ◽  
Author(s):  
María Alejandra Arriola ◽  
Diana Valencia ◽  
Carolina Olano
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Laboratory Data ◽  
Increased Risk ◽  
Frequent Finding ◽  
Male Sex ◽  
Lower Endoscopy ◽  
Small Bowel Bleeding ◽  
Nonspecific Inflammation

Introduction. The small bowel capsule endoscopy is the first line procedure in patients with suspected small bowel bleeding. Data regarding overt suspected small bowel bleeding and its predictive factors remain still limited. Aim. To assess the diagnostic yield of the capsule endoscopy and the factors predicting positive findings in patients with overt suspected small bowel bleeding. Methods. Patients with overt suspected small bowel bleeding (melena or enterorrhagia) and negative upper and lower endoscopy were included. A positive diagnostic yield was considered when the capsule endoscopy diagnosed one or more P2 or P3 type lesions (Modified Saurin Classification) Demographic and laboratory data were recorded. Results. 79 patients were included (mean age 62.92 (15-89); F:M 46:33). The diagnostic yield of the capsule endoscopy was 62%. The most frequent finding was angioectasia (44.8%), followed by nonspecific inflammation/ulceration (20.4%). The multivariate analysis found that age older than 50 years and male sex were independent variables that were associated with an increased risk of positive findings and angioectasia. Conclusions. In this group of patients with overt suspected small bowel bleeding, the capsule endoscopy was useful (with a diagnostic yield of 62%). The most frequent lesions were the vascular ones. Age over 50 and male sex were independent predictors of finding lesions and angioectasia.

Diagnostic yield of magnetically assisted capsule endoscopy versus gastroscopy in recurrent and refractory iron deficiency anemia

Endoscopy ◽  
2018 ◽  
Vol 51 (05) ◽  
pp. 409-418 ◽  
Author(s):  
Hey-Long Ching ◽  
Melissa F. Hale ◽  
Matthew Kurien ◽  
Jennifer A. Campbell ◽  
Stefania Chetcuti Zammit ◽  
...  
Keyword(s):  
Small Bowel ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Deficiency Anemia ◽  
Gi Tract ◽  
Upper Gi ◽  
Upper Gi Tract ◽  
Magnetically Assisted

Abstract Background Small-bowel capsule endoscopy is advocated and repeat upper gastrointestinal (GI) endoscopy should be considered for evaluation of recurrent or refractory iron deficiency anemia (IDA). A new device that allows magnetic steering of the capsule around the stomach (magnetically assisted capsule endoscopy [MACE]), followed by passive small-bowel examination might satisfy both requirements in a single procedure. Methods In this prospective cohort study, MACE and esophagogastroduodenoscopy (EGD) were performed in patients with recurrent or refractory IDA. Comparisons of total (upper GI and small bowel) and upper GI diagnostic yields, gastric mucosal visibility, and patient comfort scores were the primary end points. Results 49 patients were recruited (median age 64 years; 39 % male). Combined upper and small-bowel examination using the new capsule yielded more pathology than EGD alone (113 vs. 52; P < 0.001). In upper GI examination (proximal to the second part of the duodenum, D2), MACE identified more total lesions than EGD (88 vs. 52; P < 0.001). There was also a difference if only IDA-associated lesions (esophagitis, altered/fresh blood, angioectasia, ulcers, and villous atrophy) were included (20 vs. 10; P = 0.04). Pathology distal to D2 was identified in 17 patients (34.7 %). Median scores (0 – 10 for none – extreme) for pain (0 vs. 2), discomfort (0 vs. 3), and distress (0 vs. 4) were lower for MACE than for EGD (P < 0.001). Conclusion Combined examination of the upper GI tract and small bowel using the MACE capsule detected more pathology than EGD alone in patients with recurrent or refractory IDA. MACE also had a higher diagnostic yield than EGD in the upper GI tract and was better tolerated by patients.

scholarly journals Capsule Endoscopy in Inflammatory Bowel Disease: When? To Whom?

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2240
Author(s):  
Soo-Young Na ◽  
Yun-Jeong Lim
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Postoperative Recurrence ◽  
Treat To Target ◽  
Diagnostic Modality ◽  
Colon Capsule Endoscopy ◽  
Bowel Diseases ◽  
Colon Capsule ◽  
The Cost

Capsule endoscopy (CE) has proven to be a valuable diagnostic modality for small bowel diseases over the past 20 years, particularly Crohn’s disease (CD), which can affect the entire gastrointestinal tract from the mouth to the anus. CE is not only used for the diagnosis of patients with suspected small bowel CD, but can also be used to assess disease activity, treat-to-target, and postoperative recurrence in patients with established small bowel CD. As CE can detect even mildly non-specific small bowel lesions, a high diagnostic yield is not necessarily indicative of high diagnostic accuracy. Moreover, the cost effectiveness of CE as a third diagnostic test employed usually after ileocolonoscopy and MR or CT enterography is an important consideration. Recently, new developments in colon capsule endoscopy (CCE) have increased the utility of CE in patients with ulcerative colitis (UC) and pan-enteric CD. Although deflation of the colon during the examination and the inability to evaluate dysplasia-associated lesion or mass results in an inherent risk of overestimation or underestimation, the convenience of CCE examination and the risk of flare-up after colonoscopy suggest that CCE could be used more actively in patients with UC.

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