Capsule endoscopy is safe and effective after small-bowel resection
ABSTRACT Because capsule endoscopy is a relatively new technique, the indications, the contraindications, and the complications of the procedure have not been fully delineated. The present study was undertaken to determine the utility and the safety of capsule endoscopy in patients who have undergone small-bowel resection.
Ten patients (mean age 48.5 [8.4] years) were included in the study. Eight had undergone surgical resection for Crohn's disease and two for malignancy. Indications for capsule endoscopy included suspected relapse of Crohn's disease or of malignancy, with a negative conventional evaluation that included barium contrast radiography, upper endoscopy, colonoscopy, US, CT, and push enteroscopy. Capsule endoscopy was performed in the standard fashion.
No side effects were observed in any patient. Natural excretion of the capsule was reported at a mean of 72 hours. In 7 patients (70%), capsule endoscopy revealed recurrence of disease in the small bowel: one recurrent malignancy, 6 recurrent Crohn's disease. The information gained was helpful with respect to further treatment for all of these patients.
Capsule endoscopy is safe and effective in the evaluation of patients who have undergone surgical resection of the small bowel for benign or malignant disease.
- SourceAvailable from: Rita Gervasi
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- "In this case the incidental discovery of an occult bleeding lesion and a targeted surgical approach made us to ensure a suitable therapy of GI bleeding. The follow up will be done by capsule endoscopy, a safe and effective method of intestinal post operative control . "
ABSTRACT: Jejunal diverticulosis is an uncommon disease and usually asymptomatic. It can be complicated not only by diverticulitis, but by hemorrhage, perforation, intussusception, volvulus, malabsorption and even small bowel obstruction due to enteroliths formed and expelled from these diverticula. We describe a case of an occult bleeding jejunal diverticulum, casually discovered in a patient that was taken to surgery for a Dieulafoy's lesion after unsuccessful endoscopic treatment. We performed a gastric resection together with an ileocecal resection.Macroscopic and microscopic examinations confirmed the gastric Dieulafoy's lesion and demonstrated the presence of another source of occult bleeding in asymptomatic jejunal diverticulum. The current case emphasizes that some gastrointestinal bleeding lesions, although rare, can be multiple and result in potentially life-threatening bleeding. The clinician must be mindful to the possibility of multisite lesions and to the correlation between results of the investigations and clinical condition of the bleeding patient.BMC Surgery 11/2012; 12 Suppl 1(Suppl 1):S29. DOI:10.1186/1471-2482-12-S1-S29 · 1.24 Impact Factor
Article: Small bowel endoscopy[Show abstract] [Hide abstract]
ABSTRACT: Video capsule endoscopy continues to be the major focus in papers dealing with diagnostic small-bowel endoscopy. Although capsule endoscopy is used for a variety of indications, its major field of application is still obscure bleeding from the small intestine, where it can be regarded as a first-line test. There is increasing evidence that capsule endoscopy for suspected Crohn's disease may be diagnostic in individual cases after inconclusive conventional tests. Push enteroscopy is the clinical reality for biopsy and treatment in the proximal small bowel, whereas intraoperative enteroscopy is used for distal or diffuse small-intestinal disorders. Further reports on double-balloon enteroscopy suggest that this method may be able to replace at least intraoperative enteroscopy in many circumstances. The availability of specific antibody tests for celiac disease is leading to recurrent interest in endoscopy and histology, showing that villous atrophy and lymphocytic infiltrates are typical, but not specific, findings.Endoscopy 03/2005; 37(2):122-32. DOI:10.1055/s-2004-826155 · 5.20 Impact Factor
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ABSTRACT: Few advances in the history of gastroenterology have made as dramatic an impact on the diagnosis of gastrointestinal disease as the development and rapid clinical implementation of wireless capsule endoscopy. Less than 4 years after the landmark publication, capsule endoscopy is widely considered an essential component of the diagnostic workup of obscure gastrointestinal bleeding, and its role is expanding in the diagnosis of small bowel diseases such as Crohn's disease. This review appraises the available literature and highlights practical aspects of capsule endoscopy of interest to the clinician. We discuss safety concerns, optimal preparation for the procedure, diagnostic utility as compared to conventional methods, indications for capsule endoscopy, and outcomes.Clinical Gastroenterology and Hepatology 06/2005; 3(5):411-22. DOI:10.1016/S1542-3565(05)00019-4 · 6.53 Impact Factor