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GE-Portuguese Journal of Gastroenterology

Print version ISSN 2341-4545

Abstract

ROSA, Bruno et al. Pan-Enteric Capsule Endoscopy: Current Applications and Future Perspectives. GE Port J Gastroenterol [online]. 2024, vol.31, n.2, pp.13-24.  Epub Apr 15, 2024. ISSN 2341-4545.  https://doi.org/10.1159/000533960.

Background:

The role of capsule endoscopy in the evaluation of the small bowel is well established, and current guidelines position it as a first-line test in a variety of clinical scenarios. The advent of double-headed capsules further enabled the endoscopic assessment of colonic mucosa and the opportunity for a one-step noninvasive examination of the entire bowel (panenteric capsule endoscopy [PCE]).

Summary:

We reviewed the technical procedure and preparation of patients for PCE, as well as its current clinical applications and future perspectives. In non-stricturing and non-penetrating Crohn’sdisease affecting the small bowel and colon, PCE monitors disease activity by assessing mucosal healing, a major treatment outcome, with a higher diagnostic yield than cross-sectional imaging or conventional colonoscopy. Also in ulcerative colitis, double-headed capsules have been used to monitor disease activity noninvasively. Currently, validated scoring systems have been specifically devised for these double-headed capsules and permit a standardized assessment of the inflammatory burden. In suspected mid-lower digestive bleeding, some exploratory studies have demonstrated the feasibility and high diagnostic yield of PCE, which may work as a filter indicating which patients may benefit of further invasive procedures, namely, for planned hemostatic procedures. The possibility of using PCE is also discussed in the context of polyposis syn-dromes with simultaneous involvement of the small intestine and colon.

Key Messages:

PCE is a feasible, effective, and safe diagnostic procedure to evaluate the small bowel and colon. It has been increasingly explored in the setting of inflammatory bowel diseases and, more recently, in suspected mid-lower digestive bleeding. PCE is expected to reduce the demand for invasive procedures and expand the scope of noninvasive intestinal evaluation in the coming future.

Keywords : Capsule endoscopy; Panenteric endoscopy; Digestive bleeding; Inflammatory bowel disease; Crohn’s disease.

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