Abstract:
BACKGROUND:Capsule endoscopy (CE) is a new device that enables visualization of areas of the small bowel that were previously inaccessible through other noninvasive procedures. The purpose of this study is to evaluate this new diagnostic tool and its efficacy in finding occult GI tract pathology. METHODS:A single-institution retrospective review was completed on patients undergoing CE from January 2002 to September 2004. Data evaluated included indications for CE, results of previous studies, CE findings, and complications of the CE study. RESULTS:A total of 702 CE studies in 652 patients were performed during the study period. Suspicious GI bleeding presenting as anemia, guaiac positive stools, or history of gross bleeding were the most common reasons to perform CE (75.8%). Other indications included abdominal pain (11.5%), diarrhea (3.1%), or others (9.5%). In studies performed for GI bleeding (N = 532), a source was found in 49.3% of CE studies. Arteriovenous malformation (AVM) was the most common reported finding (43.9%), followed by ulcer (24.1%), colon or gastric pathology (14.1%), mass/tumor (9.1%), and stricture (6.9%). Patients with abdominal pain (n = 81) had findings 46.9% of the time including edema/ulcer (47.4%), stricture (10.5%), mass/tumor (26.3%), gastric pathology (10.5%), AVM (2.6%), or sprue (2.6%). Patients with diarrhea (n = 22) had findings 45.5% of the time including edema/ulcer (75%), mass/tumor (12.5%), or sprue (12.5%). A total of 66 patients underwent operative exploration after a CE study at this institution either because of the observed findings or for other reasons. There were 12 (1.7%) CE studies in which the capsule was retained and required surgical removal. Pathology at the retention site included benign strictures or adhesions (n = 9, 75%), Crohn's stricture (n = 1, 8.3%) carcinoid tumor (n = 1, 8.3%), and villous adenoma (n = 1, 8.3%). CONCLUSIONS:CE is an accurate study to locate abnormalities in the GI tract that may have either been missed by previous diagnostic studies or cannot be observed through other non-invasive means. When used for diagnostic challenges such as GI bleeding with no apparent source, CE can be helpful in guiding surgical decisions in patients and thus should be integrated as part of the diagnostic workup.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Carlo JT,DeMarco D,Smith BA,Livingston S,Wiser K,Kuhn JA,Lamont JPdoi
10.1016/j.amjsurg.2005.08.015subject
Has Abstractpub_date
2005-12-01 00:00:00pages
886-90issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(05)00713-0journal_volume
190pub_type
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journal_title:American journal of surgery
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pub_type: 杂志文章,随机对照试验
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更新日期:2011-01-01 00:00:00
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更新日期:2006-12-01 00:00:00
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更新日期:2011-09-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章,评审
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更新日期:1995-09-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:2005-05-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:2014-09-01 00:00:00
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journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
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更新日期:2017-01-01 00:00:00