[Evaluation of capsule endoscopy on the diagnosis of gastrointestinal diseases].
OBJECTIVE
To investigate the diagnostic value of capsule endoscopy in patients with gastrointestinal diseases of unknown causes (especially with small intestinal diseases).


METHODS
The clinical data and images from M2A capsule endoscopy of 100 consecutive patients from 2004 to 2009 in Peking University Third Hospital were analyzed. These patients were followed up by telephone.


RESULTS
The patients with metoclopramide (10 mg, intramuscular injection) had a significantly shorter gastric transit time in capsule endoscopy than those without metoclopramide (15.0 min vs 30.5 min, P=0.019). Among the patients with obscure gastrointestinal bleeding (n=40), abdominal pain or discomfort (n=35) and diarrhea (n=18), the rate of definitive diagnosis was 60.0%, 80.0% and 72.2%, respectively. The overall diagnostic yield of capsule endoscopy was 67.6%, 42.9% and 44.4%. The accuracy of capsule endoscopy was 75.0%, 92.9% and 84.6%. The sensitivity of capsule endoscopy for small intestinal diseases was 77.3%, 87.5% and 66.7%. The specificity was 50.0%, 95.0% and 90.0%. The positive predictive value was 94.4%, 87.5% and 66.7%. The negative predictive value was 16.7%, 95.0% and 90.0%, respectively.


CONCLUSIONS
M2A capsule endoscopy with its high diagnostic value was a good method in the diagnosis of gastrointestinal diseases, especially in the patients with small intestinal diseases. There were differences in aspect of the diagnostic value among patients with different indications. Metoclopramide was helpful to reduce the gastric transit time of patients referred for capsule endoscopy.
Song
Zhi-qiang
ZQ
Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China.
Gu
Fang
F
Yao
Wei
W
Li
Jun
J
Zhou
Li-ya
LY
Lin
San-ren
SR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008787:Metoclopramide; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
D008787:Metoclopramide