Evaluation of Small-Bowel Patency in Crohn's Disease: Prospective Study with a Patency Capsule and Computed Tomography.
Capsule endoscopy
Diagnosis and imaging
Gastrointestinal radiology
Inflammatory bowel disease
Small-bowel endoscopy
Journal
GE Portuguese journal of gastroenterology
ISSN: 2341-4545
Titre abrégé: GE Port J Gastroenterol
Pays: Switzerland
ID NLM: 101685861
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
13
11
2018
accepted:
14
03
2019
entrez:
14
12
2019
pubmed:
14
12
2019
medline:
14
12
2019
Statut:
ppublish
Résumé
Patency capsule (PC) examination is usually performed - previously to capsule endoscopy - to evaluate small-bowel patency in patients with established Crohn's disease (CD). The reported PC retention rate is significantly higher than expected. Our aims were to assess small-bowel patency, to determine the precise location of the retained PC in patients with CD, and to determine the false positive rate of evaluation with a radiofrequency identification tag (RFIT) scanner. This is a prospective single-center study including CD patients with clinical indication for small-bowel capsule endoscopy. PillCam® PC examination was performed on all patients to assess small-bowel patency. On all patients with a positive identification of the PC using an RFIT scanner, 30 h after ingestion, an abdominal CT was performed in order to identify its precise location. Fifty-four patients were included. The PC retention rate, according to evaluation with the RFIT scanner, was 20% (in 11 patients) 30 h after ingestion. These patients were then submitted to abdominal CT, which revealed that there was small-bowel retention in 5 cases (9%). Higher CRP levels, penetrating disease, and a history of abdominal surgery were associated with an increased risk of PC retention ( The small-bowel PC retention rate (9%) was considerably lower than those found in previous reports. Our results show that, with this protocol, the false-positive cases of RFIT scans or plain abdominal X-rays may be avoided. This may contribute to more extensive application of capsule endoscopy without the risk of small-bowel retention.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Patency capsule (PC) examination is usually performed - previously to capsule endoscopy - to evaluate small-bowel patency in patients with established Crohn's disease (CD). The reported PC retention rate is significantly higher than expected. Our aims were to assess small-bowel patency, to determine the precise location of the retained PC in patients with CD, and to determine the false positive rate of evaluation with a radiofrequency identification tag (RFIT) scanner.
METHODS
METHODS
This is a prospective single-center study including CD patients with clinical indication for small-bowel capsule endoscopy. PillCam® PC examination was performed on all patients to assess small-bowel patency. On all patients with a positive identification of the PC using an RFIT scanner, 30 h after ingestion, an abdominal CT was performed in order to identify its precise location.
RESULTS
RESULTS
Fifty-four patients were included. The PC retention rate, according to evaluation with the RFIT scanner, was 20% (in 11 patients) 30 h after ingestion. These patients were then submitted to abdominal CT, which revealed that there was small-bowel retention in 5 cases (9%). Higher CRP levels, penetrating disease, and a history of abdominal surgery were associated with an increased risk of PC retention (
DISCUSSION
CONCLUSIONS
The small-bowel PC retention rate (9%) was considerably lower than those found in previous reports. Our results show that, with this protocol, the false-positive cases of RFIT scans or plain abdominal X-rays may be avoided. This may contribute to more extensive application of capsule endoscopy without the risk of small-bowel retention.
Identifiants
pubmed: 31832494
doi: 10.1159/000499722
pii: pjg-0026-0396
pmc: PMC6876578
doi:
Types de publication
Journal Article
Langues
eng
Pagination
396-403Informations de copyright
Copyright © 2019 by S. Karger AG, Basel.
Déclaration de conflit d'intérêts
The authors declare that they have no conflict of interest.
Références
Am J Gastroenterol. 2006 Oct;101(10):2218-22
pubmed: 16848804
Dig Dis Sci. 2008 Oct;53(10):2732-8
pubmed: 18320313
Inflamm Bowel Dis. 2018 Oct 12;24(11):2339-2347
pubmed: 29718225
Gastrointest Endosc. 2009 Mar;69(3 Pt 1):602-3; author reply 603-4
pubmed: 19231509
Gastroenterol Res Pract. 2016;2016:9657053
pubmed: 26880902
Endoscopy. 2005 Oct;37(10):1065-7
pubmed: 16189792
J Gastroenterol. 2010 Jul;45(7):721-31
pubmed: 20428899
J Crohns Colitis. 2016 Dec;10(12):1445-1447
pubmed: 27194532
Gastrointest Endosc. 2011 Oct;74(4):834-9
pubmed: 21839995
Dig Liver Dis. 2013 Jul;45(7):558-61
pubmed: 23238033
Exp Ther Med. 2013 Jul;6(1):115-120
pubmed: 23935731
Therap Adv Gastroenterol. 2017 Aug;10(8):589-598
pubmed: 28835773
Endoscopy. 2014;46 Suppl 1 UCTN:E662-3
pubmed: 25526414
Transl Res. 2012 Apr;159(4):313-25
pubmed: 22424434
Dig Liver Dis. 2006 May;38(5):326-30
pubmed: 16527556
Inflamm Bowel Dis. 2002 Jul;8(4):244-50
pubmed: 12131607
World J Gastroenterol. 2008 Sep 14;14(34):5269-73
pubmed: 18785278
Digestion. 2015;91(4):318-25
pubmed: 25998955
Endoscopy. 2016 Apr;48(4):373-9
pubmed: 26561918
J Int Med Res. 2016 Aug;44(4):968-75
pubmed: 27377071
J Clin Gastroenterol. 2007 Jul;41(6):576-82
pubmed: 17577114
Dig Endosc. 2017 Jul;29(5):519-546
pubmed: 28370422
J Crohns Colitis. 2017 Oct 1;11(10):1288
pubmed: 28486597
Nagoya J Med Sci. 2018 Feb;80(1):121-128
pubmed: 29581621
J Crohns Colitis. 2013 Dec;7(12):982-1018
pubmed: 24184171
Hepatogastroenterology. 2015 Jan-Feb;62(137):240-4
pubmed: 25911903
Endoscopy. 2005 Sep;37(9):808-15
pubmed: 16116530
Rev Esp Enferm Dig. 2016 Feb;108(2):65-70
pubmed: 26838487
Gastrointest Endosc. 2008 May;67(6):902-9
pubmed: 18355824