title: Use of an external real-time image viewer coupled with prespecified actions enhanced the complete examinations for capsule endoscopy.
abstract: OBJECTIVE
  The clinical utility of capsule endoscopy (CE) is often limited by incomplete small-bowel transit. The aim was to determine whether the use of an external real-time viewer could reduce delays caused by delayed gastric emptying of the capsule or delayed intestinal transit and also improve the rate of positive findings.
  
  
  METHODS
  We compared the proportion of completed exams and positive results among a group of patients studied before introduction of real-time viewer and a group in which capsule transit through the esophagus, stomach, and small bowel was regularly monitored and actions (e.g. administration of water or intravenous metoclopramide) were taken if it was delayed.
  
  
  RESULTS
  One hundred procedures in the viewer group and 100 control procedures in the age-matched controls were analyzed. In the viewer group, additional water intake (22 cases) and/or administration of metoclopramide (26 cases) were required. Endoscopic-assisted duodenal placement of the capsule was required in three cases. Overall one-third (n=33) of cases required viewer-prompted interventions. The completion rate (86% vs 66%, P=0.002) and the rate of positive findings (80% vs 67%, P=0.04) were significantly higher in the viewer group compared to the no viewer group.
  
  
  CONCLUSIONS
  Checking the progress of the capsule with the external real-time viewer improved the diagnostic yield and completion rate of CE.
authors: Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan. shiotani@med.kawasaki-m.ac.jp
authors: Akiko
authors: A
authors: Shiotani
authors: Keisuke
authors: K
authors: Honda
authors: Makiko
authors: M
authors: Kawakami
authors: Ryuji
authors: R
authors: Nishi
authors: Takahisa
authors: T
authors: Murao
authors: Manabu
authors: M
authors: Ishii
authors: Hiroshi
authors: H
authors: Matsumoto
authors: Hiroaki
authors: H
authors: Kusunoki
authors: Jiro
authors: J
authors: Hata
authors: Ken
authors: K
authors: Haruma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000295:instrumentation*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003199:Computer Systems; D005260:Female; D005746:Gastric Emptying; D005772:Gastrointestinal Transit / Q000187:drug effects; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007410:Intestinal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D007564:Japan; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D008787:Metoclopramide