A novel diagnostic tool for detecting functional patency of the small bowel: the Given patency capsule.
OBJECTIVE
The current visualization of small-bowel strictures using traditional radiological methods is associated with high radiation doses and false-negative results. These methods do not always reveal small-bowel patency for solids. The aim is to assess the safety of the Given patency system and its ability to detect intestinal strictures in patients with strictures that are known or suspected radiologically.


METHODS
The Given patency capsule is composed of lactose, remains intact in the gastrointestinal tract for 40-100 hours post ingestion, and disintegrates thereafter. A total of 34 patients with small-bowel stricture were prospectively enrolled; 30 had a previous diagnosis of Crohn's disease, three had adhesion syndrome and in one ischemic enteritis was suspected. Of the patients, 15 (44.1 %) had previously undergone surgery. Following ingestion, the capsule was monitored for integrity and transit time, using a specially designed Given scanner and also radiologically. Seventeen patients had been enrolled with the intent of using the patency capsule as a preliminary test in patients with small-bowel strictures before undergoing video capsule endoscopy.


RESULTS
30 patients (88.2 %) retrieved the capsule in the stool; it was intact in 20 (median transit time 22 hours), and disintegrated in 10 patients (median transit time 53 hours). Six patients complained of abdominal pain which disappeared within 24 hours. The scanner successfully indicated the presence of the capsule in 94 % of cases. Ten patients underwent video capsule endoscopy following the patency capsule examination; in all of these the video capsule passed through the small-bowel stricture.


CONCLUSIONS
This feasibility study has shown that the Given patency capsule is a safe, effective, and convenient tool for assessment of functional patency of the small bowel. It can indicate functional patency even in cases where traditional radiology indicates stricture.
Spada
C
C
Digestive Endoscopy Unit, Catholic University, A. Gemelli University Hospital, Largo A. Gemelli 8, 00168 Rome, Italy.
Spera
G
G
Riccioni
M
M
Biancone
L
L
Petruzziello
L
L
Tringali
A
A
Familiari
P
P
Marchese
M
M
Onder
G
G
Mutignani
M
M
Perri
V
V
Petruzziello
C
C
Pallone
F
F
Costamagna
G
G
D000328:Adult; D002214:Capsules; D003251:Constriction, Pathologic; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis*; D007421:Intestine, Small / Q000000981:diagnostic imaging; D008297:Male; D011446:Prospective Studies; D011859:Radiography
D002214:Capsules