scholarly journals Capsule Endoscopy in the Investigation of Patients with Portal Hypertension and Anemia

2008 ◽  
Vol 22 (5) ◽  
pp. 469-474 ◽  
Author(s):  
Spyros Goulas ◽  
Konstantina Triantafyllidou ◽  
Stephanos Karagiannis ◽  
Panayiota Nicolaou ◽  
Petros Galanis ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Small Bowel ◽  
Capsule Endoscopy ◽  
Matched Control ◽  
Normal Liver ◽  
Portal Hypertensive Gastropathy ◽  
Endoscopic Techniques ◽  
Colonic Varices ◽  
Endoscopic Characteristics ◽  
Portal Hypertensive Enteropathy

INTRODUCTION: Data on small bowel abnormalities in patients with portal hypertension (PHT) are limited. Bleeding from the gastrointestinal tract and anemia are common complications in these patients. Capsule endoscopy (CE) was used to evaluate small bowel (SB) pathology in patients with PHT and anemia, and possible associations with various parameters were examined.METHODS: Thirty-five patients with PHT referred for CE investigation of the SB for anemia were prospectively enrolled in the study, as well as 70 age- and sex-matched control patients with anemia, normal liver function and no evidence of PHT who underwent CE.RESULTS: Findings compatible with portal hypertensive enteropathy (PHE) were detected in 65.7% of the patients and in 15.7% of the controls (χ2=26.641, P=0.000). Abnormalities in PHT patients included varices in 25.7%, diffuse changes of mucosa with inflammatory-like appearance in 42.9%, and angiodysplasias and/or spider angiomas in 22.9% of cases. The presence of PHE was significantly associated only with the presence of severe portal hypertensive gastropathy, while the presence of SB varices alone was significantly associated with the presence of severe portal hypertensive gastropathy, larger esophageal varices and the presence of colonic varices.CONCLUSIONS: Varices, diffuse changes of mucosa with inflammatory-like appearance, and angiodysplasias and/or spider angiomas are detected more often in patients with PHT than in controls, and probably constitute the endoscopic characteristics of PHE. CE of the SB added a significant number of likely important findings to those detected by conventional endoscopic techniques for the clinical management of patients with PHT and anemia.

Small-bowel lesions caused by portal hypertension of schistosomal origin: a capsule endoscopy pilot study

2010 ◽  
Vol 71 (4) ◽  
pp. 861-866 ◽  
Author(s):  
Ricardo L. Ganc ◽  
Carlos A. Malheiros ◽  
Seiji Nakakubo ◽  
Luis A. Szutan ◽  
Arnaldo J. Ganc
Keyword(s):  
Portal Hypertension ◽  
Pilot Study ◽  
Small Bowel ◽  
Capsule Endoscopy

Portal Hypertension Severity Does Not Predict Capsule Endoscopy Findings in the Small Bowel of Patients with Liver Cirrhosis and Chronic Anemia

2009 ◽  
Vol 69 (5) ◽  
pp. AB203 ◽  
Author(s):  
Maria Elena Riccioni ◽  
Brigida E. Annicchiarico ◽  
Carmine Di Stasi ◽  
Cristiano Spada ◽  
Riccardo Urgesi ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Small Bowel ◽  
Capsule Endoscopy ◽  
Chronic Anemia

Is small-bowel capsule endoscopy effective for diagnosis of esophagogastric lesions related to portal hypertension?

2014 ◽  
Vol 29 (3) ◽  
pp. 511-516 ◽  
Author(s):  
Taiki Aoyama ◽  
Shiro Oka ◽  
Hiroshi Aikata ◽  
Makoto Nakano ◽  
Ikue Watari ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Small Bowel ◽  
Capsule Endoscopy

scholarly journals P096 Which patients with known Crohn’s disease after an ileo-colonoscopy will benefit most from small bowel capsule endoscopy?

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S193-S194
Author(s):  
N Viazis ◽  
A Mountaki ◽  
K Koustenis ◽  
C Veretanos ◽  
K Arvanitis ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Terminal Ileum ◽  
Imaging Techniques ◽  
Clinical Manifestations ◽  
Endoscopic Techniques ◽  
Proximal Small Bowel ◽  
Number Of Patients

Abstract Background Ileo-colonoscopy with biopsies is considered the gold standard for the diagnosis and management of Crohn’s disease (CD). In contrast, the role of small bowel capsule endoscopy (SBCE) is limited currently in cases where ileo-colonoscopy and imaging techniques raise doubts on the diagnosis or cannot explain certain clinical manifestations of Crohn’s disease. The aim of our study was to determine whether there are patients with endoscopically confirmed established CD who could get additional benefit by SBCE. Methods Retrospective analysis of prospectively collected data from 6301 patients subjected to SBCE in our department from 1st March 2003 to 18th February 2021. Patients with CD diagnosed by ileo-colonoscopy or total colonoscopy only (because the ileo-caecal valve could not be intubated) prior to SBCE were included in the study and biopsies. SBCE had been performed only in patients who lacked any clinical and/or imaging (CT/MRE) evidence of bowel obstruction. The presence and extent of mucosal lesions, namely local and/or diffuse erythema, erosions and ulcers (aphthous, superficial and/or deep) throughout the small intestine, which may be difficult to identify by traditional imaging, could either explain clinical manifestations unrelated to the findings of colonoscopy or led onto reassessment of applied treatments were sought by SBCE. Results The study sample consisted of 1002 patients (males/females: 511/491, mean age ± SD: 52.6±27.3). Among these, CD had been diagnosed with colonoscopy (and not ileo-colonoscopy) in 293 (29.2%) subjects and small bowel involvement was seen in 104 (35.5%) patients. The vast majority of these patients had lesions only in the terminal ileum (n=81, 77.8%), while the remaining patients (n=23, 22.2%) had additional lesions in more proximal parts of the small bowel. Among the 709 (70.8%) patients in whom CD had been diagnosed by ileo-colonoscopy, lesions in the terminal ileum were found in 407 (57.4 %) patients; SBCE revealed more proximal lesions in 104 patients (25.5%). In the remaining 307 patients (43.3%) in whom ileo-colonoscopy did not reveal terminal ileum involvement, more proximal small bowel lesions were seen in 35 (11.4%) patients. These lesions were mainly apthoid ulcers or larger ulcers, findings that led to a change in therapeutic management in 17 patients (48.6%). Conclusion SBCE identifies more proximal small bowel lesions in a substantial number of patients with CD established by traditional endoscopic techniques. When these lesions are more severe and extensive they may lead onto re-evaluation of the personalized therapeutic strategies.

Spectrum of small-bowel mucosal abnormalities identified by capsule endoscopy in patients with portal hypertension of varied etiology

2017 ◽  
Vol 36 (1) ◽  
pp. 32-37 ◽  
Author(s):  
T. S. Chandrasekar ◽  
Gokul Bollu Janakan ◽  
Viveksandeep Thoguluva Chandrasekar ◽  
Raja Yogesh Kalamegam ◽  
Sathiamoorthy Suriyanarayanan ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Small Bowel ◽  
Capsule Endoscopy

Screening and surveillance for hereditary polyposis and non-polyposis syndromes with capsule endoscopy

2008 ◽  
Vol 149 (14) ◽  
pp. 639-644 ◽  
Author(s):  
Márta Kovács ◽  
Péter Pák ◽  
Gábor Pák ◽  
János Fehér
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Mr Enterography ◽  
Test Results ◽  
Push Enteroscopy ◽  
Surgical Interventions ◽  
Endoscopic Techniques ◽  
Screening And Surveillance ◽  
Polyposis Syndromes ◽  
Peutz Jeghers Syndrome

The hereditary polyposis syndromes and non-polyposis colorectal carcinoma have been considered as scarcely occuring but inheritable dominant autosomal syndromes. The increasing risk of small bowel carcinoma and prevention of obstruction and intussusception have been making frequent and acute surgical interventions inavoidably led to the necessity of screening and surveillance the patients. Earleir the diagnosis of these symptoms was difficult to establish because traditional radiological methods have a low yield for small polyps. Futhermore, small bowel is only partially accessible with traditional endoscopic techniques such as upper endoscopy, colonoscopy and push-enteroscopy. The “wireless” capsule endoscopy has opened the way then for the non-invasive and painless test of the entire small intestine. – Test results have been cumulated to justify the efficiency and safety of capsule endoscopy concerning the syndromes above. This method can be applied safely even consequently to repeatedly performed surgical interventions by low risk of capsule retention. As the results compared of the diagnosed familial adenomatous polyposis and of Peutz–Jeghers syndrome reflect on capsule endoscopy, its diagnostic sensitiveness is stated as significantly higher than the Barium-contrast X-Ray and MR-enterography. Nevertheless, determination of size and localisation of polypus has becoming more problematic when evaluating the test results.

scholarly journals Malignant Small Bowel Tumors: Diagnosis, Management and Prognosis

2015 ◽  
Vol 28 (4) ◽  
pp. 448 ◽  
Author(s):  
Hélder Cardoso ◽  
João Tiago Rodrigues ◽  
Margarida Marques ◽  
Armando Ribeiro ◽  
Filipe Vilas-Boas ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Imaging Techniques ◽  
Bowel Cancer ◽  
First Year ◽  
Small Bowel Tumors ◽  
Small Bowel Cancer ◽  
Endoscopic Techniques ◽  
High Degree ◽  
Late Stages

<p><strong>Purpose:</strong> Despite being rare entities, the incidence of malignant small bowel tumors seems to be rising. The development of capsule endoscopy and balloon assisted enteroscopy provided an advance in the assessment of small bowel lesions. We aim to describe the clinical and pathological characteristics of patients with small bowel cancer and ascertain what roles these endoscopic techniques currently have.<br /><strong>Material and Methods:</strong> A retrospective study of patients diagnosed with small bowel cancer, from January 2010 to October 2014, was performed. The data was submitted to statistical analysis.<br /><strong>Results:</strong> Of the 28 diagnosed patients, 54% were female. The mean age at diagnosis was 61 years. Adenocarcinoma was the most frequent tumor (n = 11), followed by sarcoma (n = 6), lymphoma (n = 6) and neuroendocrine tumors (n = 3). The main form of presentation was related to blood loss or intestinal obstruction. By the time of diagnosis, 46% of patients had distant metastasis/ unresectable cancer. Most of the tumors were diagnosed by endoscopic (41%) or imaging techniques (35%). In the first year after diagnosis, 29% of patients died. In multivariate analysis, adenocarcinoma remained an independent factor for worse survival.<br /><strong>Discussion:</strong> Patients with adenocarcinoma presented at late stages and with unresectable tumors, contributing to a worse outcome. A high degree of clinical suspicion for the diagnosis of small bowel cancer is necessary.<br /><strong>Conclusion: </strong>The characteristics of the patients were generally consistent with those described in the literature. Capsule endoscopy and balloon assisted enteroscopy are useful in the diagnosis, management and surveillance of small bowel cancer.</p>

Portal Hypertensive Enteropathy in Small-Bowel Capsule Endoscopy

2012 ◽  
Vol 10 (6) ◽  
pp. e54-e55 ◽  
Author(s):  
Anastasios Koulaouzidis ◽  
Gillian Ritchie ◽  
John N. Plevris
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Portal Hypertensive Enteropathy

Small Bowel Crohn's Disease: An Emerging Disease Phenotype?

2014 ◽  
Vol 33 (1) ◽  
pp. 42-51 ◽  
Author(s):  
Barry Hall ◽  
Grainne Holleran ◽  
Deirdre McNamara
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
De Novo ◽  
Mr Enterography ◽  
Anatomical Location ◽  
Cross Sectional ◽  
Endoscopic Techniques ◽  
Distinct Disease

An increasing understanding of the pathogenesis of Crohn's disease (CD), coupled with improvements in therapeutic options, has promoted the concept of stratifying patients with CD into distinct disease phenotypes according to risk. Small bowel CD, due to the numerous non-specific potential symptoms and the anatomical location of the disease, is a particularly difficult phenotype to identify. The fact that the majority of de novo strictures occur in the ileum/ileo-colonic region ensures that recognition of small bowel involvement is essential. Certainly, it is becoming increasingly recognised due to improvements in imaging and endoscopic techniques. Both CT and MR enterography appear capable of accurately diagnosing small bowel CD. Furthermore, the development of capsule endoscopy and balloon-assisted enteroscopy allow direct visualisation of the small bowel. Limited data to date would suggest that small bowel CD is a difficult entity to treat even in the current era of the ever-expanding field of biological therapies. Further long-term follow-up studies are necessary using both small bowel capsule endoscopy and cross-sectional imaging to truly assess, firstly, whether small bowel CD is more resistant to treatment and, secondly, whether it has an effect over time in terms of complications. In the future, serological and genetic tests, coupled with the aforementioned investigations, will permit early diagnosis and early treatment of small bowel CD.

scholarly journals Role of Mucosal Protrusion Angle in Discriminating Between True and False Masses of the Small Bowel on Video Capsule Endoscopy

2019 ◽  
Vol 8 (4) ◽  
pp. 418 ◽  
Author(s):  
May Min ◽  
Michael Noujaim ◽  
Jonathan Green ◽  
Christopher Schlieve ◽  
Aditya Vaze ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Acute Angle ◽  
Video Capsule Endoscopy ◽  
Small Bowel Tumors ◽  
Exact Test ◽  
Endoscopic Techniques ◽  
Extrinsic Compression ◽  
Low Incidence

The diagnosis of small-bowel tumors is challenging due to their low incidence, nonspecific presentation, and limitations of traditional endoscopic techniques. In our study, we examined the utility of the mucosal protrusion angle in differentiating between true submucosal masses and bulges of the small bowel on video capsule endoscopy. We retrospectively reviewed video capsule endoscopies of 34 patients who had suspected small-bowel lesions between 2002 and 2017. Mucosal protrusion angles were defined as the angle between the small-bowel protruding lesion and surrounding mucosa and were measured using a protractor placed on a computer screen. We found that 25 patients were found to have true submucosal masses based on pathology and 9 patients had innocent bulges due to extrinsic compression. True submucosal masses had an average measured protrusion angle of 45.7 degrees ± 20.8 whereas innocent bulges had an average protrusion angle of 108.6 degrees ± 16.3 (p < 0.0001; unpaired t-test). Acute angle of protrusion accurately discriminated between true submucosal masses and extrinsic compression bulges on Fisher’s exact test (p = 0.0001). Our findings suggest that mucosal protrusion angle is a simple and useful tool for differentiating between true masses and innocent bulges of the small bowel.

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