Use of the Given Patency System for the screening of patients at high risk for capsule retention.
BACKGROUND
Capsule enteroscopy is a non-invasive diagnostic tool for the study of the small bowel. Due to the risk of capsule retention, capsule enteroscopy is contraindicated in patients with suspected small bowel strictures. The Given Patency Capsule is a disintegration time-controlled capsule developed to identify patients with strictures that may cause capsule enteroscopy retention. The presence of the patency capsule within the patient's body can be detected by a radio-frequency scanner.


OBJECTIVE
To evaluate safety and usefulness of the patency capsule in preventing capsule retention in patients at high risk.


METHODS
Thirty-two patients were studied. Indications for patency capsule were: (A) Crohn's disease (18), (B) previous intestinal surgery (7), (C) previous obstruction (1), A+B (3), A+C (1), B+C (2). Patients were evaluated with the scanner at 72 h from ingestion.


RESULTS
At 72 h, 24 patients had already excreted the intact capsule in the stool. Of these, two experienced abdominal pain during capsule passage. In the other eight patients, the scanner detected the presence of the patency capsule. Four of them excreted the capsule intact in the stool after 72-96 h, the remaining four never found the capsule in the stool. The 26 patients who excreted the patency capsule intact without experiencing abdominal pain were deemed eligible for the capsule enteroscopy procedure, which was performed uneventfully in the 25 who agreed to undergo the examination.


CONCLUSIONS
The patency capsule is useful to identify, among patients at high risk, those who can be submitted to capsule enteroscopy without risks of capsule retention.
Signorelli
C
C
Department of Internal Medicine, Gastroenterology and Gastrointestinal Service Ospedale Maggiore Policlinico, Mangiagalli and Regina Elena Foundation, University of Milan, Via Pace 9, 20122 Milan, Italy.
Rondonotti
E
E
Villa
F
F
Abbiati
C
C
Beccari
G
G
Avesani
E C
EC
Vecchi
M
M
de Franchis
R
R
D000328:Adult; D002214:Capsules; D003251:Constriction, Pathologic; D000075202:Contraindications; D003424:Crohn Disease / Q000473:pathology*; D003663:Decision Trees; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000209:etiology*; D007421:Intestine, Small; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012307:Risk Factors
D002214:Capsules