Z-line examination by the PillCam SB: prospective comparison of three ingestion protocols.
OBJECTIVE
To evaluate the Z-line visualization by the PillCam SB2 using three different ingestion protocols.


METHODS
Ninety consecutive patients undergoing small bowel capsule endoscopy (SBCE) between January and May 2008 were included in the study. They swallowed the capsule in the standing (Group A = 30), supine (Group B = 30) and right supine positions (Group C = 30). Baseline patient characteristics, difficulties in capsule ingestion, esophageal transit times (ETT) and Z-line visualization were noted.


RESULTS
No significant differences were found between the groups with regard to baseline patient characteristics, ingestion difficulties and complete SB examinations (P > 0.05). At least 1 frame of the Z-line was detected in 15.8%, 46.7% and 90% of patients in groups A, B and C, respectively (P < 0.001). The average number of Z-line images was 0.21 +/- 0.53, 3.23 +/- 6.59 and 5.53 +/- 7.55 and the mean % of the Z-line detected was 71.3, 25.1 and 8.3, in groups A, B and C, respectively (both P < 0.001). ETT times were longer in the supine group followed by the right supine and the standing groups (median of 237 s vs 64 s and 39 s, respectively; P < 0.001).


CONCLUSIONS
Z-line visualization in patients undergoing SBCE can be accurately achieved in most cases when the capsule is swallowed in the right supine position.
Fernandez-Urien
Ignacio
I
Department of Gastroenterology, Hospital of Navarra, Irunlarrea 3, 31080 Pamplona, Spain. ifurien@yahoo.es
Borobio
Erika
E
Elizalde
Inmaculada
I
Irisarri
Rebeca
R
Vila
Juan Jose
JJ
Urman
Jesus Maria
JM
Jimenez
Javier
J
D000328:Adult; D000368:Aged; D053705:Capsule Endoscopes; D053704:Capsule Endoscopy / Q000379:methods*; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000473:pathology*; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016683:Supine Position