Abstract

BARREIRO, Pedro et al. Small-bowel capsule endoscopy in clinical practice: A single-center 5 year experience with 528 examinations and review of the literature. J Port Gastrenterol. [online]. 2012, vol.19, n.1, pp.12-20. ISSN 0872-8178.

INTRODUCTION: Video-capsule enteroscopy has revolutionized the diagnosis of small bowel pathology in the last 10 years. In our Hospital, this technique was introduced in early 2006. OBJECTIVES: Review our experience of the first 5 years of using this technique, analyzing the indications, diagnosis, complications and limitations of a sample of everyday clinical practice. METHODS : We reviewed retrospectively our experience collecting data, indications, diagnosis and complications of every exams performed between January 2006 and December 2010 following by a descriptive statistical analysis of data obtained. RESULTS: There were 528 examinations in 488 patients (56% women) with mean age 60 ± 19 [14-95] years. Transit times in the stomach and small bowel were 34.6 ± 49.6 [0-480] and 252.3 ± 87.7 [15-530] minutes. The cecum was not achieved in 13% of cases (due to recording limit in 10.4%). Main indications for examination were obscure gastrointestinal bleeding (70.3%, 2/3 iron deficiency anemia) and Crohn’s disease (14.6%, almost 2/3 suspected). The percentage of findings was 70% in obscure gastrointestinal bleeding, with no important difference between the visible and occult forms, although more relevant findings reported in the visible form. Angiectasies were diagnosed in 50.6% and erosions/ulcers in 32% of all cases of HDO. In 13.7% of cases the cause could be attributed to injury within the reach of conventional endoscopy. The percentage of findings was 32% in suspected Crohn’s disease. There were two retentions due to small bowel stenosis which required surgery. DISCUSSION : Video-capsule enteroscopy is safe and has high detection rate of lesions, particularly in patients with obscure gastrointestinal bleeding, even in an everyday clinical practice and predominance of iron deficiency anemia. There is a high percentage of lesions within reach of the endoscope and there should be a low threshold for repeating the conventional endoscopy. In suspected Crohn’s disease the detection rate of relevant lesions was low, which can be improved problaby with better selection criteria

Keywords : small bowel capsule endoscopy; obscure gastrointestinal bleeding; Crohn’s disease.

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