Limited ability of capsule endoscopy to detect normally positioned duodenal papilla.
BACKGROUND
The current power of capsule endoscopy (CE) to diagnose patients with obscure GI bleeding is 42% to 74.4%.


OBJECTIVE
The aim of this study was to evaluate the diagnostic power of CE through its ability to detect duodenal papilla.


METHODS
A total of 112 consecutive CEs were retrospectively reviewed. All patients had undergone esophagogastroduodenoscopy and had their normal duodenal papilla confirmed.


METHODS
The CE findings were reviewed separately at a rate of 15 images/second by 2 experienced and competent capsule readers.


METHODS
The CE detection rate of duodenal papilla was calculated. In addition, the number of frames showing duodenal papilla was counted.


RESULTS
Among the total CEs, 2 cases were excluded because the capsule could not traverse the second portion of duodenum. The most common indication was obscure GI bleeding. CE only detected duodenal papilla in 48 cases (43.6%). The mean number of frames of the visualizing duodenal papilla was 3.5 +/- 2.5 (range 1-13).


CONCLUSIONS
Choosing duodenal papilla as the reference may not be optimal because its position is difficult to identify.


CONCLUSIONS
Our study conveys an important message on the present power of CE; we should carefully review CE findings at a slower review rate to raise the detection ability of the current-powered CE, when it is passing through several "difficult to identify" locations such as second portion of the duodenum. In addition, to raise the power of CE, technologic improvements of CE, such as an extracorporeal-controllable device or a multiside viewing capsule, are needed.
Kong
Hwi
H
Department of Internal Medicine, Center for Digestive Disease, Korea University College of Medicine, Seoul, Korea.
Kim
Yong Sik
YS
Hyun
Jong Jin
JJ
Cho
Young Jig
YJ
Keum
Bora
B
Jeen
Yoon Tae
YT
Lee
Hong Sik
HS
Chun
Hoon Jai
HJ
Um
Soon Ho
SH
Lee
Sang Woo
SW
Choi
Jai Hyun
JH
Kim
Chang Duck
CD
Ryu
Ho Sang
HS
Hyun
Jin Hai
JH
D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology*; D053704:Capsule Endoscopy; D016145:Endoscopy, Digestive System; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity