Initial experience of wireless-capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology.
OBJECTIVE
Small bowel pathology can be diagnosed using enteroscopy (which has limitations) and by x-ray (which is not sensitive for flat lesions). For the first time ever, we used a new technique, wireless-capsule video endoscopy, to diagnose small bowel pathology. Our aim was to prove the effectiveness and safety of this technology.


METHODS
We used the Given (M2A) system in 35 patients, aged 18-80 yr, who suffered from unexplained GI bleeding or in whom there was a clinical suspicion of small bowel disease. All patients had a small bowel x-ray. Patients with suspected narrowing of the bowel or a clinical suspicion of intestinal obstruction, or with a history of major abdominal surgery, were excluded from the study. No pregnant women or patients with diabetes mellitus were included.


RESULTS
Abnormal findings were found in 29 of 35 (82.9%) patients. Twenty-two of 29 (75.9%) patients had significant pathological findings explaining their clinical situation. Diagnostic yield was therefore 62.9% (22 of 35 patients). Among the various findings, the capsule detected ulcers, erosions, angiodysplasia, and submucosal lesions. The source of bleeding was found in 15 of 20 patients with iron deficiency anemia. There were no immediate significant side effects and none reported up to 1 month after ingestion of the capsule. The capsule was evacuated by all patients.


CONCLUSIONS
The wireless-capsule video endoscope, in our study of feasibility, was proven to be a safe, painless, ambulatory, and effective procedure, with a high diagnostic yield. Its major importance is in diagnosing small bowel pathology where all other imaging techniques have failed.
Scapa
Eitan
E
Institute of Gastroenterology, Hepatology and Nutrition, Assaf Harofeh Medical Center, Zerifin, Israel.
Jacob
Harold
H
Lewkowicz
Shlomo
S
Migdal
Michal
M
Gat
Daniel
D
Gluckhovski
Arkady
A
Gutmann
Nurit
N
Fireman
Zvi
Z
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects / Q000379:methods*; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007410:Intestinal Diseases / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D014741:Video Recording