title: Diagnostic yield of spiral enteroscopy when performed for the evaluation of abnormal capsule endoscopy findings.
abstract: BACKGROUND
  Spiral enteroscopy (SE) has emerged as a new alternative for deep intubation of the small intestine. SE is most often used to evaluate abnormal findings on capsule endoscopy (CE).
  
  
  OBJECTIVE
  Investigate the ability of SE to reproduce abnormal findings detected on preceding CE.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Two academic tertiary care centers.
  
  
  METHODS
  Consecutive patients undergoing SE to investigate a clinically significant finding on CE.
  
  
  METHODS
  Ability of SE to identify findings on CE.
  
  
  RESULTS
  Total of 56 anterograde SE procedures were performed. CE findings included arteriovenous malformations (AVMs) (n=26), masses (n=8), ulcers (n=4), polyps (n=4), abnormal mucosa (n=6), fresh blood (n=6), and stricture (n=1). Majority of the patients had CE findings located in the jejunum (41 of 56 or 73.2%). Mean depth of enteroscope insertion was 224.6±68.7 cm. SE detected relevant small bowel pathology in 32 of 56 (57.1%) patients. Findings on CE were reproduced in 30 of 56 (53.6%) cases. Reproducibility was independent of patient body mass index (P=0.38), CE indication (P=0.24), CE lesion location (P=0.29), days between CE and SE (P=0.30), and depth of insertion (P=0.81). Type of CE findings (particularly AVMs) significantly affected SE reproducibility (P=0.015). SE procedure time was inversely related to SE reproducibility (odds ratio=0.94, 95% confidence interval=0.88-0.99, P=0.02).
  
  
  CONCLUSIONS
  Small sample size and potential for false-positive CE study.
  
  
  CONCLUSIONS
  SE seems to be moderately effective (57.1%) in terms of its ability to locate pathology within the small intestine. The type of small bowel pathology targeted by SE may affect its clinical utility. AVMs observed on CE can be seen at the time of SE in the majority of cases (60%).
authors.affiliation: Department of Medicine, Stony Brook University Medical Center, State University of New York, Stony Brook, NY 11794, USA. jmbuscaglia@notes.cc.sunysb.edu
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Buscaglia
authors.forename: Robert
authors.initials: R
authors.lastname: Richards
authors.forename: Mark N
authors.initials: MN
authors.lastname: Wilkinson
authors.forename: Joel R
authors.initials: JR
authors.lastname: Judah
authors.forename: Yvette
authors.initials: Y
authors.lastname: Lam
authors.forename: Satish
authors.initials: S
authors.lastname: Nagula
authors.forename: Peter V
authors.initials: PV
authors.lastname: Draganov
mesh_terms: D000368:Aged; D001165:Arteriovenous Malformations / Q000175:diagnosis / Q000473:pathology; D053704:Capsule Endoscopy / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D011446:Prospective Studies