Diagnostic yield of spiral enteroscopy when performed for the evaluation of abnormal capsule endoscopy findings.
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%).
Buscaglia
Jonathan M
JM
Department of Medicine, Stony Brook University Medical Center, State University of New York, Stony Brook, NY 11794, USA. jmbuscaglia@notes.cc.sunysb.edu
Richards
Robert
R
Wilkinson
Mark N
MN
Judah
Joel R
JR
Lam
Yvette
Y
Nagula
Satish
S
Draganov
Peter V
PV
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