Clinical relevance of small-bowel findings detected by wireless capsule endoscopy.
OBJECTIVE
Capsule endoscopy is becoming known as a valid tool for identifying sources of obscure gastrointestinal (GI) bleeding. Fewer data are available about its clinical value for other indications.


METHODS
Sixty patients (31 F, mean age 47 years, range 14-80 years) with no signs of overt GI bleeding were investigated by Given M2A video capsule for suspected small-bowel disease. The main clinical features were: iron deficient anemia (20), abdominal pain (12), chronic diarrhea (9), malabsorption and weight loss (7), Crohn's disease (CD) (5), and familial adenomatous polyposis (3). Three patients underwent wireless endoscopy for suspected GI neoplasm and one for portal thrombosis.


RESULTS
Complete vision of the small bowel was achieved in 55 patients. No small-bowel lesions were identified in 17 patients, but 5 of them had gastric abnormalities. Small-bowel abnormality was found in 38 patients. Lesions compatible with CD were found in 14 patients, diffuse or patchy enteropathy in 7 and polyps in 6. Actively bleeding lesions were detected in 6 patients and potential bleeding sources in 5. Capsule endoscopy had an overall diagnostic yield of 62%. In particular, three small-bowel malignancies were detected and 9 patients received a better definition of their already-known pathology. However, further endoscopies were needed in 10 patients to obtain a diagnosis. One patient, diagnosed with ileal CD, underwent surgery, as the capsule remained trapped in a stricture.


CONCLUSIONS
Wireless endoscopy effectively visualizes small-bowel abnormalities even though more accurate selection of the patients is needed in order to optimize its diagnostic efficacy.
Sturniolo
Giacomo C
GC
Department of Surgical and Gastroenterological Sciences, Gastroenterology Section, universityof Padua, Italy. gc.sturniolo@unipd.it
Di Leo
Vincenza
V
Vettorato
Maria G
MG
D'Inca
Renata
R
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D019723:Endoscopes; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis*; D007413:Intestinal Mucosa / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D007558:Italy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index