title: Incomplete capsule endoscopy examinations after Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Video capsule endoscopy is an important tool for minimally invasive evaluation of the small bowel. Optimization of this imaging modality has focused on minimizing the rate of incomplete studies through appropriate patient selection. Recent data have shown an increased incidence of incomplete examinations in those with surgically altered gastrointestinal anatomy.
  
  
  METHODS
  We present 4 consecutive cases of post Roux-en-Y gastric bypass patients undergoing video capsule endoscopy.
  
  
  RESULTS
  Three patients were referred for obscure gastrointestinal bleeding and one for diagnosis of Crohn's disease; all 4 patients had incomplete studies. One patient experienced capsule retention in the gastric pouch. Two patients had repeated poor small bowel preparation despite compliance with preparatory methods. The fourth patient experienced delayed gastrointestinal transit despite satisfactory small bowel preparation.
  
  
  CONCLUSIONS
  Patients with a history of Roux-en-Y surgery appear to be at increased risk for incomplete examination due to capsule retention and delayed gastric transit. Endoscopists may consider additional precursory testing or the use of alternative imaging methods in this population.
authors.affiliation: Department of Gastroenterology, UC Davis Medical Center, Sacramento, USA. dhavan15@gmail.com.|Department of Internal Medicine, UC Davis Medical Center, 4150 V Street, PSSB 3116, Sacramento, CA, 95817-1460, USA. dhavan15@gmail.com.
authors.forename: Dhavan A
authors.initials: DA
authors.lastname: Parikh
authors.affiliation: UC Davis School of Medicine, Sacramento, CA, USA.
authors.forename: Mohit
authors.initials: M
authors.lastname: Mittal
authors.affiliation: Department of Gastroenterology, UC Davis Medical Center, Sacramento, USA.|Department of Gastroenterology, Sacramento VA Medical Center, VANCHCS, Mather, CA, USA.
authors.forename: Surinder K
authors.initials: SK
authors.lastname: Mann
keywords: Roux-en-Y; Small bowel; Video capsule endoscopy