title: Limited ability of capsule endoscopy to detect normally positioned duodenal papilla.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Center for Digestive Disease, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hwi
authors.initials: H
authors.lastname: Kong
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Kim
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Hyun
authors.forename: Young Jig
authors.initials: YJ
authors.lastname: Cho
authors.forename: Bora
authors.initials: B
authors.lastname: Keum
authors.forename: Yoon Tae
authors.initials: YT
authors.lastname: Jeen
authors.forename: Hong Sik
authors.initials: HS
authors.lastname: Lee
authors.forename: Hoon Jai
authors.initials: HJ
authors.lastname: Chun
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Um
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Lee
authors.forename: Jai Hyun
authors.initials: JH
authors.lastname: Choi
authors.forename: Chang Duck
authors.initials: CD
authors.lastname: Kim
authors.forename: Ho Sang
authors.initials: HS
authors.lastname: Ryu
authors.forename: Jin Hai
authors.initials: JH
authors.lastname: Hyun
mesh_terms: 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