title: Performance of the patency capsule compared with nonenteroclysis radiologic examinations in patients with known or suspected intestinal strictures.
abstract: BACKGROUND
  The patency capsule (PC) is used before capsule endoscopy (CE) in patients with known or suspected small-bowel (SB) strictures or obstruction (SBO) to avoid CE retention. False-positive PC examination results can occur in patients with delayed transit without obstruction, precluding the use of CE. Radiological tests are another option to evaluate the presence of SBO before CE.
  
  
  OBJECTIVE
  Comparison of the PC and radiological examinations to detect clinically significant SB strictures.
  
  
  METHODS
  Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PC, and radiological tests for detecting significant strictures.
  
  
  RESULTS
  Forty-two patients underwent a PC study and radiological examinations. Both of the examinations showed similar sensitivity (57% vs 71%; P = 1.00) and specificity (86% vs 97%; P = .22). The receiver-operating characteristic curves evaluating combined sensitivity and specificity were also similar in both the PC and radiological examinations (0.71 vs 0.84, respectively; P = .46). Pooling results from both the PC and radiological tests had the highest sensitivity and NPV (100%, 100%). False-positive results occurred in 5 PC examinations and 1 radiological examination. The PC examination had 3 false-negative results (9%), whereas radiological tests had 2 (6%).
  
  
  CONCLUSIONS
  Retrospective study.
  
  
  CONCLUSIONS
  The NPV for the PC and radiological tests were not significantly different, suggesting that if findings on either test are negative before CE, the patient will most likely pass the capsule without incident. Radiological tests can be used to minimize PC study false-positive results by confirming or excluding the presence of a significant stricture suspected by the PC and to localize the PC if passage is delayed.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: Anitha
authors.initials: A
authors.lastname: Yadav
authors.forename: Russell I
authors.initials: RI
authors.lastname: Heigh
authors.forename: Amy K
authors.initials: AK
authors.lastname: Hara
authors.forename: G Anton
authors.initials: GA
authors.lastname: Decker
authors.forename: Michael D
authors.initials: MD
authors.lastname: Crowell
authors.forename: Suryakanth R
authors.initials: SR
authors.lastname: Gurudu
authors.forename: Shabana F
authors.initials: SF
authors.lastname: Pasha
authors.forename: David E
authors.initials: DE
authors.lastname: Fleischer
authors.forename: Lucinda A
authors.initials: LA
authors.lastname: Harris
authors.forename: Janice
authors.initials: J
authors.lastname: Post
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Leighton
mesh_terms: D053704:Capsule Endoscopy; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed