title: Contraindications for video capsule endoscopy.
abstract: Video capsule endoscopy (VCE) has been applied in the last 15 years in an increasing field of applications. Although many contraindications have been put into perspective, some precautions still have to be considered. Known stenosis of the gastrointestinal tract is a clear contraindication for VCE unless surgery is already scheduled or at least has been considered as an optional treatment modality. In patients with a higher incidence of stenosis, as in an established diagnosis of Crohn's disease, clinical signs of obstruction, prior radiation or surgical small bowel resection, a preceding test with the self-dissolving patency capsule can override this contraindication. Endoscopic placement of the capsule should be considered in patients with swallowing disorders to avoid aspiration. Esophageal or gastric motility disorders may require endoscopic capsule transport or application of prokinetics if the real-time viewer proofs delayed transit. In pregnant women, VCE should be restricted to urgent cases where diagnosis cannot be postponed after delivery, as data on safety are missing. There is theoretical and clinical evidence that patients with implanted cardiac devices such as a pacemaker, cardioverters or left heart assist devices, can safely undergo VCE in spite of still existing contraindication by manufacturers. Children from the age of 2 years have safely undergone VCE. Although video capsules are not proven safe with magnetic resonance imaging (MRI), first single cases of patients incidentally undergoing MRI with an incorporated capsule have been reported, showing susceptibility artifacts but no signs of clinical harm.
authors.affiliation: Dirk Bandorski, Matthias Hecker, University of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), 35392 Giessen, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Bandorski
authors.affiliation: Dirk Bandorski, Matthias Hecker, University of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), 35392 Giessen, Germany.
authors.forename: Niehls
authors.initials: N
authors.lastname: Kurniawan
authors.affiliation: Dirk Bandorski, Matthias Hecker, University of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), 35392 Giessen, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Baltes
authors.affiliation: Dirk Bandorski, Matthias Hecker, University of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), 35392 Giessen, Germany.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Hoeltgen
authors.affiliation: Dirk Bandorski, Matthias Hecker, University of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), 35392 Giessen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hecker
authors.affiliation: Dirk Bandorski, Matthias Hecker, University of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), 35392 Giessen, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Stunder
authors.affiliation: Dirk Bandorski, Matthias Hecker, University of Giessen and Marburg Lung Center, Member of the German Center for Lung Research (DZL), 35392 Giessen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Keuchel
mesh_terms: D000367:Age Factors; D053704:Capsule Endoscopy; D003251:Constriction, Pathologic; D000075202:Contraindications; D017147:Defibrillators, Implantable; D003680:Deglutition Disorders; D015154:Esophageal Motility Disorders; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006353:Heart-Assist Devices; D006801:Humans; D010138:Pacemaker, Artificial; D011247:Pregnancy
keywords: Aspiration; Contraindications; Magnetic resonance imaging; Pacemaker; Pregnancy; Stenosis; Video capsule endoscopy