A prospective trial comparing wireless capsule endoscopy and barium contrast series for small-bowel surveillance in hereditary GI polyposis syndromes.
BACKGROUND
Capsule endoscopy has demonstrated its clinical utility in the evaluation of the small bowel, and, accordingly, it has been suggested that it could be useful for the identification of small-intestinal polyps in patients with polyposis syndromes. The objective was to establish the effectiveness of wireless capsule endoscopy for detecting small-bowel polyps in patients with hereditary GI polyposis syndromes in comparison with barium contrast series.


METHODS
Consecutive patients with GI polyposis syndromes were included. Small-bowel follow-through series and capsule endoscopy were performed within 1 week, in a blind fashion. The number and the location of polyps were analyzed.


RESULTS
Twenty-four patients with familial adenomatous polyposis (n = 20) or Peutz-Jeghers syndrome (n = 4) were included. Capsule endoscopy detected small-bowel polyps in 7 of 24 patients (29%), whereas a barium contrast study identified small-intestinal polyps in only 3 of these 7 patients. In the 4 remaining patients, all of them with familial adenomatous polyposis, polyps detected by the capsule but missed in radiographic series were located at either ileum (2 patients), jejunum (1), or duodenum (1). No procedure-related complication was observed in any patient.


CONCLUSIONS
Wireless capsule endoscopy is a highly accurate technique for the detection of small-bowel polyps in patients with hereditary GI polyposis syndromes, and it represents a valuable alternative to barium contrast series in the surveillance of patients with Peutz-Jeghers syndrome.
Mata
Alfredo
A
Digestive Endoscopy Unit, Gastroenterology Department, Institut de Malaties Digestives, Barcelona, Catalonia, Spain.
Llach
Josep
J
Castells
Antoni
A
Rovira
Josep M
JM
Pellisé
María
M
Ginès
Angels
A
Fernández-Esparrach
Gloria
G
Andreu
Montserrat
M
Bordas
Josep M
JM
Piqué
Josep M
JM
D000285:Administration, Rectal; D000328:Adult; D001466:Barium Sulfate / Q000008:administration & dosage; D002214:Capsules; D003287:Contrast Media / Q000008:administration & dosage*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004733:Enema / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D010580:Peutz-Jeghers Syndrome / Q000175:diagnosis*; D011446:Prospective Studies; D011859:Radiography; D015203:Reproducibility of Results; D013686:Telemetry
D002214:Capsules; D003287:Contrast Media; D001466:Barium Sulfate