title: Clinical usefulness of transabdominal ultrasonography prior to patency capsule for suspected small-bowel strictures.
abstract: OBJECTIVE
  Patency capsule (PC) examination has made it possible to perform capsule endoscopy (CE) in patients with a suspected small-bowel stricture. However, PC has some drawbacks, so we assessed the usefulness of transabdominal ultrasonography (TUS) prior to PC in patients with suspected small-bowel strictures to avoid unnecessary PC examination.
  
  
  METHODS
  Fifty-two patients who underwent TUS prior to PC were enrolled in this study. TUS findings were classified as follows: intestinal narrowing and distension at the oral side (Type A); extensive bowel wall thickening (Type B); focal bowel wall thickening (Type C) or no abnormality detected (Type D). We evaluated the TUS and PC findings for the detection of small-bowel strictures.
  
  
  RESULTS
  Double-balloon endoscopy (DBE) revealed small-bowel strictures in 13 of 50 patients (26%). TUS yielded Type B or C findings in 12 of 13 patients (92%), while PC revealed strictures in all 13 patients. In Crohn's disease (CD) patients with Type B TUS findings, 8 of 9 (89%) had small-bowel strictures on DBE. However, only two of six non-CD patients (33%) with Type B TUS findings had small-bowel strictures. The incidence of Type B strictures was significantly higher in CD patients.
  
  
  CONCLUSIONS
  CD patients with Type B TUS findings should not undergo PC or CE because of the high rate of small-bowel strictures. Non-CD patients diagnosed with Type B TUS strictures, as well as patients diagnosed with Type C or D strictures should undergo CE after confirming small-bowel patency using PC.
authors.affiliation: a Department of Gastroenterology and Metabolism , Graduate School of Biomedical Sciences, Hiroshima University , Minami-Ku , Hiroshima , Japan ;
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakano
authors.affiliation: b Department of Endoscopy , Hiroshima University Hospital , Minami-Ku , Hiroshima , Japan ;
authors.forename: Shiro
authors.initials: S
authors.lastname: Oka
authors.affiliation: b Department of Endoscopy , Hiroshima University Hospital , Minami-Ku , Hiroshima , Japan ;
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: a Department of Gastroenterology and Metabolism , Graduate School of Biomedical Sciences, Hiroshima University , Minami-Ku , Hiroshima , Japan ;
authors.forename: Sayoko
authors.initials: S
authors.lastname: Kunihara
authors.affiliation: a Department of Gastroenterology and Metabolism , Graduate School of Biomedical Sciences, Hiroshima University , Minami-Ku , Hiroshima , Japan ;
authors.forename: Atushi
authors.initials: A
authors.lastname: Igawa
authors.affiliation: a Department of Gastroenterology and Metabolism , Graduate School of Biomedical Sciences, Hiroshima University , Minami-Ku , Hiroshima , Japan ;
authors.forename: Taiki
authors.initials: T
authors.lastname: Aoyama
authors.affiliation: c Department of Gastroenterology , JA Onomichi General Hospital , Hiroshima , Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Imagawa
authors.affiliation: c Department of Gastroenterology , JA Onomichi General Hospital , Hiroshima , Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Onogawa
authors.affiliation: b Department of Endoscopy , Hiroshima University Hospital , Minami-Ku , Hiroshima , Japan ;
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Ueno
authors.affiliation: c Department of Gastroenterology , JA Onomichi General Hospital , Hiroshima , Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Hanada
authors.affiliation: a Department of Gastroenterology and Metabolism , Graduate School of Biomedical Sciences, Hiroshima University , Minami-Ku , Hiroshima , Japan ;
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000379:methods*; D003251:Constriction, Pathologic / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology; D003424:Crohn Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D058582:Double-Balloon Enteroscopy; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D055815:Young Adult
keywords: Capsule endoscopy; Crohn’s disease; double-balloon endoscopy; small-bowel disease