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      Capsule Retentions and Incomplete Capsule Endoscopy Examinations: An Analysis of 2300 Examinations

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          Abstract

          Aim. To evaluate capsule endoscopy in terms of incomplete examinations and capsule retentions and to find risk factors for these events. Material and Methods. This retrospective and consecutive study includes data from 2300 capsule enteroscopy examinations, performed at four different hospitals in Stockholm, Sweden from 2003 to 2009. Results. The frequency of incomplete examinations was 20%. Older age, male gender, suspected, and known Crohn's disease were risk factors for an incomplete examination. The PillCam capsule had the highest rate of completed examinations. Capsule retention occurred in 1.3% ( n = 31). Risk factors for capsule retention were known Crohn's disease and suspected tumor. Complications of capsule retention were acute obstructive symptoms in six patients and one death related to complications after acute surgical capsule retrieval. Conclusion: Capsule endoscopy is considered a safe procedure, although obstructive symptoms and serious complications due to capsule retention can be found in a large series of patients.

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          Wireless capsule endoscopy.

          G Iddan, G Meron, A Glukhovsky … (2000)
          Article 0 comments Cited 431 times – based on 0 reviews     Review now
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            Indications and detection, completion, and retention rates of small-bowel capsule endoscopy: a systematic review.

            Zhuan Liao, Rui Gao, Can Xu … (2010)
            Capsule endoscopy (CE) has been widely used in clinical practice. To provide systematically pooled results on the indications and detection, completion, and retention rates of small-bowel CE. A systematic review. We searched the PubMed database (2000-2008) for original articles relevant to small-bowel CE for the evaluation of patients with small-bowel signs and symptoms. Data on the total number of capsule procedures, the distribution of different indications for the procedures, the percentages of procedures with positive detection (detection rate), complete examination (completion rate), or capsule retention (retention rate) were extracted and/or calculated, respectively. In addition, the detection, completion, and retention rates were also extracted and/or calculated in relation to indications such as obscure GI bleeding (OGIB), definite or suspected Crohn's disease (CD), and neoplastic lesions. A total of 227 English-language original articles involving 22,840 procedures were included. OGIB was the most common indication (66.0%), followed by the indication of only clinical symptoms reported (10.6%), and definite or suspected CD (10.4%). The pooled detection rates were 59.4%; 60.5%, 55.3%, and 55.9%, respectively, for overall, OGIB, CD, and neoplastic lesions. Angiodysplasia was the most common reason (50.0%) for OGIB. The pooled completion rate was 83.5%, with the rates being 83.6%, 85.4%, and 84.2%, respectively, for the 3 indications. The pooled retention rates were 1.4%, 1.2%, 2.6%, and 2.1%, respectively, for overall and the 3 indications. Inclusion and exclusion criteria were loosely defined. The pooled detection, completion, and retention rates are acceptable for total procedures. OGIB is the most common indication for small-bowel CE, with a high detection rate and low retention rate. In addition, angiodysplasia is the most common finding in patients with OGIB. A relatively high retention rate is associated with definite or suspected CD and neoplasms.
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              Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: report of 100 consecutive cases.

              G Beccari, C Abbiati, Roberto De Masi … (2004)
              Capsule endoscopy (CE) is a promising diagnostic tool for the study of patients with obscure gastrointestinal bleeding. However, the diagnostic yield of this technique has not been adequately studied. We evaluated sensitivity and specificity of CE and the outcome after CE in patients with obscure gastrointestinal bleeding. One hundred consecutive patients (all with recent negative upper and lower endoscopy; 26 with ongoing overt bleeding [group A], 31 with previous overt bleeding [group B], and 43 with guaiac-positive stools and iron-deficiency anemia [group C]) underwent CE. The yield of positive findings on CE was 92.3% in group A, 12.9% in group B, and 44.2% in group C (P < 0.0001, A vs. B, A vs. C). Angiodysplasia (29%) and Crohn's disease (6%) were the most common diagnoses. Sensitivity, specificity, and positive and negative predictive values of CE were 88.9%, 95%, 97%, and 82.6%, respectively. CE results led to treatments resolving the bleeding in 86.9% of patients undergoing the procedure while actively bleeding. Capsule retention because of unsuspected stenosis occurred in 5 patients and required surgery, which resolved the clinical problem, in 4 patients. CE is an effective diagnostic tool for patients with obscure GI bleeding. The best candidates for the procedure are those with ongoing obscure-overt bleeding or with obscure-occult bleeding. If done early in the course of the workup, CE could shorten considerably the time to diagnosis, lead to definitive treatment in a relevant proportion of patients, and spare a number of alternative investigations with low diagnostic yield.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Gastroenterol Res Pract
                Journal ID (publisher-id): GRP
                Title: Gastroenterology Research and Practice
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 1687-6121
                ISSN (Electronic): 1687-630X
                Publication date (Print): 2012
                Publication date (Electronic): 29 September 2011
                Volume: 2012
                Electronic Location Identifier: 518718
                Affiliations
                1Department of Medicine, Karolinska Institute, Stockholm Söder Hospital, 118 83 Stockholm, Sweden
                2Department of Gastroenterology and Hepatology, Karolinska University Hospital, 141 86 Stockholm, Sweden
                3Department of Gastroenterology, Ersta Hospital, 116 91 Stockholm, Sweden
                4Department of Medicine, Danderyd Hospital, 182 88 Stockholm, Sweden
                Author notes
                *Charlotte M. Höög: charlotte.hoog@ 123456ki.se

                Academic Editor: Marco Pennazio

                Article
                DOI: 10.1155/2012/518718
                PMC ID: 3182761
                PubMed ID: 21969823
                SO-VID: c53cec9e-c87a-417d-94b0-a688e46ee3c6
                Copyright © Copyright © 2012 Charlotte M. Höög et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 25 May 2011
                Date revision received : 19 July 2011
                Date accepted : 31 July 2011
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Gastroenterology & Hepatology
                Data availability:
                ScienceOpen disciplines: Gastroenterology & Hepatology

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