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 IMPACT OF SMALL BOWEL CAPSULE ENDOSCOPY IN IRON DEFICIENCY ANEMIA: INFLUENCE OF PATIENT’SAGE ON DIAGNOSTIC YIELD

2018 ◽  
Vol 55 (3) ◽  
pp. 242-246 ◽  
Author(s):  
Sofia XAVIER ◽  
Joana MAGALHÃES ◽  
Bruno ROSA ◽  
Maria João MOREIRA ◽  
José COTTER
Keyword(s):  
Small Bowel ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Capsule Endoscopy ◽  
Diagnostic Yield ◽  
Vascular Lesions ◽  
Deficiency Anemia ◽  
Age Group ◽  
Single Center Study ◽  
Significant Pathology

ABSTRACT BACKGROUND: Iron deficiency anemia remains one of the main indications to perform small bowel capsule endoscopy. Literature suggests that diagnostic yield is influenced by patient’s age but with conflicting results regarding age cutoff. OBJECTIVE: We aimed to clarify the differences in diagnostic yield and incidence of specific findings according to age. METHODS: Retrospective single-center study including 118 patients performing small bowel capsule endoscopy in the study of iron deficiency anemia. Videos were reviewed and small bowel findings that may account for anemia were reported. Incomplete examinations were excluded. Findings were compared between patients ≤60 and >60 years. RESULTS: Patients had a mean age of 58 years old (SD ±17.9) with 69.5% females (n=82). The overall diagnostic yield was 49% (58/118), being higher among patients >60 years (36/60, diagnostic yield 60%) than those ≤60 years (20/58, diagnostic yield 34%), (P<0.01). Angioectasias were more frequent in patients >60 years (45% vs 9%, P<0.01). Patients ≤60 years presented more frequently significant inflammation (Lewis score >135 in 10.3% vs 1.7%, P<0.05) and other non-vascular lesions (24% vs 10%, P=0.04). CONCLUSION: In our cohort small bowel capsule endoscopy diagnosed clinically relevant findings in the setting of iron deficiency anemia in almost half the patients. Diagnostic yield was higher in patients older than 60 years (60%), with vascular lesions being more frequent in this age group. Despite the lower diagnostic yield in patients ≤60 years, significant pathology was also found in this age group, mainly of inflammatory type.

Video Capsule Endoscopy In Comparison To Radiological Examination In Detection Of Small Bowel Lesions

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Amir Helmy Samy ◽  
Nevine Ibrahim Musa ◽  
Shereen Abou Bakr Saleh ◽  
Ahmed Sayed Elgammal
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Positive Contrast ◽  
Video Capsule Endoscopy ◽  
Vascular Lesions ◽  
Deficiency Anemia ◽  
Mesenteric Angiography ◽  
Upper Gi ◽  
Negative Results ◽  
Upper Gi Endoscopy

Abstract BACKGROUND Small bowel obscured its lesions as secrets which were difficult to diagnose before video capsule endoscopy as a new modality for investigation. Aim of the study Evaluation of video capsule endoscopy in comparison to radiological examination in detection of small bowel lesions. Patients and methods Fifty patients were recruited from Kafrawy Video Capsule Endoscopy Unit of Internal Medicine Department and endoscopy unit of Ain Shams University Hospital. The study included patients with occult or overt GIT bleeding, patients with unexplained microcytic iron deficiency anemia, patients with chronic diarrhea and abdominal pain, with normal upper GI endoscopy and colonoscopy. Exclusion of any patient younger than 18 years old, has intestinal stricture, achalasia, or dysphagia. All patients were studied biochemically with CBC and radiological by CT pelvis and abdomen with IV and oral positive contrast some of them were radiologically examined with CTE or CT mesenteric angiography. All patients were endoscopically examined by OGD, colonoscopy, VCE, and some of them were examined also with enteroscope. Results The study revealed that the detection rate of SB lesions with VCE was 84%. In the current study, (44%) of cases had AVMs, (72.73) % of them were above the age of forty five, and (27.27) % were below the age of forty five. All patients who were investigated with CT mesenteric angiography revealed negative results. In this study (20) % of patients had SB masses and polyps, (70) % of them were at age of forty five or more and only (30) % of them were below the age of forty five. All patients underwent CT pelvis and abdomen with IV and oral positive contrast, and we found that all patients had a negative results regarding the SB lesions. In comparison between CTE and VCE in detection of SB vascular lesions CTE did not detect SB vacular lesions. On the other hand, VCE detected the AVMs in the cases with negative CTE results. In this study one patient (2)% was diagnosed with hookworm infection. All patient underwent for OGD. We found that (20)% of patients had a significant gastric or duodenal lesions (proximal to the papilla) by VCE but missed by upper GI endoscopy. In our study the concomitant of VCE and enteroscope increase the detection of SB vascular lesions than isolated use of VCE only. Conclusion VCE has a high detection rate of SB lesions (84)%. CTE has a low significance in detection of SB vascular lesions and CT mesenteric angiography sensitivity relatively low. AVMs more common with increasing the age. PHE and SB ectopic varicies, were found to be common causes of GIT bleeding in CLD patient. There is a significant rate of missed gastric and duodenal (proximal to the papilla) lesions that the cause of GIT bleeding and unexplained iron deficiency anemia in OGD examination that were detected by VCE.

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.

P.06.16: The Role of Wireless Capsule Endoscopy in the Diagnosis of Small Bowel Tumors: A Single Centre Experience

2017 ◽  
Vol 49 ◽  
pp. e170-e171
Author(s):  
G. Scarpulla ◽  
S. Camilleri ◽  
G.M.G. La Ferrera ◽  
M. Manganaro ◽  
M.F. Maida ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Wireless Capsule Endoscopy ◽  
Single Centre ◽  
Small Bowel Tumors ◽  
Single Centre Experience ◽  
Wireless Capsule

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 Bowel Preparation for Small Bowel Capsule Endoscopy: Is There Still a Role for Polyethylene Glycol?

2020 ◽  
Vol 11 (03) ◽  
pp. 215-222
Author(s):  
Paul Collins ◽  
Neil Haslam ◽  
Anthony Morris ◽  
Thomas Skouras ◽  
Ashley Bond
Keyword(s):  
Polyethylene Glycol ◽  
Small Bowel ◽  
Transit Time ◽  
Capsule Endoscopy ◽  
Bowel Preparation ◽  
Diagnostic Yield ◽  
Statistical Significance ◽  
Deficiency Anemia ◽  
Bowel Cleansing ◽  
The Impact

Abstract Objectives This study aimed to assess the impact of polyethylene glycol (PEG) bowel cleansing on performance characteristics of small bowel capsule endoscopy (SBCE). Materials and Methods Data from consecutive patients undergoing SBCE in the period before and after the introduction of PEG 2 L bowel cleansing with PEG were collated retrospectively. The indication, diagnostic yield (DY), clinical outcome, small bowel transit time, gastric transit time, and completion rate were recorded for each procedure. Results Data from 286 patients were analyzed. PEG 2 L was not superior to 12-hour fasting for DY (66 [53%] vs. 76 [47%] patients [p = 0.348]), or DY for significant findings (findings requiring a further intervention or investigation; 29 [23%] vs. 52 [32%] patients [p = 0.090]).There was a trend toward an increased DY for significant findings in patients undergoing investigation for iron-deficiency anemia (IDA) receiving PEG 2 L that just failed to meet statistical significance (13 [31%] and 25 [21%] patients, respectively [p = 0.06]). Transit times and completion rates were unaffected by bowel cleansing. Conclusion Bowel cleansing with PEG 2 L is not superior to fasting for overall DY in SBCE. PEG 2 L may confer an advantage for the detection of significant lesions in patient with IDA. Further investigation of optimal modes of bowel preparation is indicated.

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