SMALL BOWEL CAPSULE ENDOSCOPY IS A VALUABLE DIAGNOSTIC TOOL IN ISOLATED TERMINAL ILEITIS

2020 ◽  
Author(s):  
M Freitas ◽  
TC Gonçalves ◽  
PB Carvalho ◽  
FD de Castro ◽  
B Rosa ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Diagnostic Tool ◽  
Terminal Ileitis ◽  
Valuable Diagnostic Tool

scholarly journals P251 Small bowel capsule endoscopy is a valuable diagnostic tool in isolated terminal ileitis

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S275-S275
Author(s):  
M FREITAS ◽  
T Cúrdia Gonçalves ◽  
P Boal Carvalho ◽  
F Dias de Castro ◽  
B Rosa ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Diagnostic Tool ◽  
Terminal Ileum ◽  
Diagnostic Yield ◽  
Common Finding ◽  
Imaging Data ◽  
Terminal Ileitis ◽  
Faecal Calprotectin ◽  
Valuable Diagnostic Tool

Abstract Background Terminal ileitis (TI), is a common condition in clinical practice and may be associated with a wide variety of diseases. Small bowel capsule endoscopy (SBCE) is a valuable diagnostic tool for small bowel diseases; however, data regarding its diagnostic impact on isolated TI are sparse. The aim of the study was to evaluate the diagnostic value of SBCE for isolated TI detected during ileocolonoscopy. Methods Retrospective study including consecutive patients undergoing SBCE after diagnosis of TI without colonic mucosal abnormalities on ileocolonoscopy between January 2016 and September 2019. Demographic, clinical, biochemical, endoscopic and imaging data were collected. Results One hundred and two patients with isolated ileitis on ileocolonoscopy were included. Positive findings on SBCE were found in 84 (82.4%) patients, being ulcers the most common finding (76.5%). Endoscopic abnormalities proximal to terminal ileum were found in 36.3% of patients. After SBCE, 63.7% of patients had a final diagnosis, Crohn’s disease (CD) was the most common (34.3%), followed by NSAIDs enteropathy (12.7%). Elevated faecal calprotectin (p = 0.001) was independently associated with positive SBCE findings. There was a tendency for high levels of erythrocyte sedimentation rate be associated with positive findings (p = 0.07). However, the presence of symptoms, imaging abnormalities and other laboratory findings such as leukocytosis, anaemia, and elevated C-reactive protein were not predictors of positive SBCE findings. At multivariate analysis, only elevated faecal calprotectin (OR 6.0, IC 95% 1.9–18.7; p = 0.002) was a significant predictive factor for positive SBCE findings. Conclusion SBCE revealed a high diagnostic yield in patients with isolated ileitis on ileocolonoscopy enabling a definite diagnosis in almost two-thirds of patients. Approximately one-third of patients had findings proximal to terminal ileum and a similar percentage was diagnosed with CD. In patients with isolated ileitis on ileocolonoscopy, SBCE should be considered to evaluate small bowel lesions, particularly when there is an elevated faecal calprotectin, even when other clinical, imagiological or laboratorial abnormalities are absent.

scholarly journals Capsule Endoscopy for Ileitis with Potential Involvement of Other Sections of the Small Bowel

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Hyun Seok Lee ◽  
Yun Jeong Lim
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Clinical Course ◽  
Diagnostic Value ◽  
Definitive Diagnosis ◽  
Imaging Findings ◽  
Terminal Ileitis ◽  
Aphthous Ulcers ◽  
Radiologic Imaging ◽  
Inflammatory Drugs

Ileitis is defined as inflammation of the ileum. This condition includes ulcers, aphthous ulcers, erosions, and nodular or erythematous mucosa. Various etiologies are associated with ileitis. Crohn’s disease, ulcerative colitis, medications such as nonsteroidal anti-inflammatory drugs, infectious conditions, neoplasms, infiltrative disorders, vasculitides, spondyloarthritis, endometriosis, and radiation therapy-related conditions involve the ileum. However, the differential diagnosis of terminal ileitis can be difficult in many cases. Video capsule endoscopy (VCE) has become a useful tool for the diagnosis of a variety of small bowel lesions. This review describes each of the various conditions associated with ileitis and the diagnostic value of VCE for ileitis, which may help identify and evaluate these conditions in clinical practice. Based on the information provided by VCE, a definitive diagnosis could be made using the patients’ medical history, clinical course, laboratory and ileocolonoscopic findings, radiologic imaging findings, and histologic findings.

scholarly journals P168 Isolated terminal ileitis: when capsule endoscopy is key for Crohn’s disease diagnosis

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S222-S222
Author(s):  
M FREITAS ◽  
T Cúrdia Gonçalves ◽  
P Boal Carvalho ◽  
F Dias de Castro ◽  
B Rosa ◽  
...  
Keyword(s):  
Weight Loss ◽  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Disease Diagnosis ◽  
Inflammatory Activity ◽  
Extraintestinal Manifestations ◽  
Terminal Ileitis ◽  
Proximal Small Bowel

Abstract Background Terminal ileitis (TI) is a common condition in clinical practice and may be associated with a wide variety of diseases, mostly Crohn’s disease (CD). Data regarding predictors of CD diagnosis in isolated TI are lacking, particularly concerning small bowel capsule endoscopy (SBCE) findings. Aim To evaluate predictive factors for CD diagnosis in patients with isolated TI detected during ileocolonoscopy, submitted to SBCE. Methods Retrospective study including consecutive patients undergoing SBCE after diagnosis of TI without colonic mucosal abnormalities on ileocolonoscopy between January 2016 and September 2019. Demographic, clinical, biochemical, endoscopic and imaging data were collected. The diagnosis of CD was based on clinical evaluation, endoscopic, histological, radiological, and/or biochemical investigations. Results One hundred and two patients with isolated ileitis on ileocolonoscopy were included. After performing SBCE, 34.3% of the patients had a diagnosis of CD. All CD diagnosed patients had positive SBCE findings. Extraintestinal manifestations (p = 0.003), weight loss (p = 0.01), abnormal imaging (p = 0.04) and positive SBCE findings (p = 0.005) were independently associated with CD diagnosis. Regarding SBCE, presence of proximal small-bowel disease (p = 0.02), diffuse findings (p = 0.002) and presence of moderate to severe inflammatory activity (Lewis Score≥790) (p < 0.001) were independently associated with CD diagnosis. Conclusion SBCE is a valuable tool that should be systematically used in patients presenting with isolated TI, since it enabled CD diagnosis in approximately one-third of patients. A diagnosis of CD should be considered when a patient with TI shows extraintestinal manifestations, weight loss, abnormal imaging and positive SBCE findings, especially proximal involvement, diffuse findings and the presence of moderate to severe inflammatory activity.

scholarly journals Is It Possible to Predict the Presence of Intestinal Angioectasias?

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Tiago Cúrdia Gonçalves ◽  
Joana Magalhães ◽  
Pedro Boal Carvalho ◽  
Maria João Moreira ◽  
Bruno Rosa ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Gastrointestinal Bleeding ◽  
Predictive Factors ◽  
Capsule Endoscopy ◽  
Diagnostic Tool ◽  
Diagnostic Yield ◽  
Vascular Lesions ◽  
Important Diagnostic Tool ◽  
The Mean

Background and Aim. Angioectasias are the most common vascular anomalies found in the gastrointestinal tract. In small bowel (SB), they can cause obscure gastrointestinal bleeding (OGIB) and in this setting, small bowel capsule endoscopy (SBCE) is an important diagnostic tool. This study aimed to identify predictive factors for the presence of SB angioectasias, detected by SBCE. Methods. We retrospectively analyzed the results of 284 consecutive SBCE procedures between April 2006 and December 2012, whose indication was OGIB, of which 47 cases with SB angioectasias and 53 controls without vascular lesions were selected to enter the study. Demographic and clinical data were collected. Results. The mean age of subjects with angioectasias (70.9±14.7) was significantly higher than in controls (53.1±18.6; P<0.001). The presence of SB angioectasias was significantly higher when the indication for the exam was overt OGIB versus occult OGIB (13/19 versus 34/81, P=0.044). Hypertension and hypercholesterolemia were significantly associated with the presence of SB angioectasias (38/62 versus 9/38, P<0.001 and 28/47 versus 19/53, P=0.027, resp.). Other studied factors were not associated with small bowel angioectasias. Conclusions. In patients with OGIB, overt bleeding, older age, hypercholesterolemia, and hypertension are predictive of the presence of SB angioectasias detected by SBCE, which may be used to increase the diagnostic yield of the SBCE procedure and to reduce the proportion of nondiagnostic examinations.

scholarly journals P576 The value of small bowel capsule endoscopy in the change of therapeutic management in patients with established Crohn’s disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S484-S485
Author(s):  
N Viazis ◽  
E Tsoukali ◽  
C Pontas ◽  
G Karampekos ◽  
F Gkeros ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Terminal Ileum ◽  
Therapeutic Management ◽  
Clinical Relapse ◽  
Terminal Ileitis ◽  
Disease Extent ◽  
Disease Location

Abstract Background Small bowel capsule endoscopy (SBCE) is widely used for various indications in patients with established Crohn’s disease (CD). Our aim was to investigate whether SBCE can lead to changes in the therapeutic management of CD patients. Methods Retrospective analysis of prospectively collected data [September 2003 - September 2019] from patients with established CD subjected to SBCE in two tertiary referral centres for inflammatory bowel diseases. All patients were tested with the Pillcam SB. Findings consistent with small bowel CD involvement were the presence of aphthoid or larger ulcers with or without inflammation of the adjacent mucosa. Results In total, 839 patients [median age (range) 36 (17–78) years, 471 (56.41%) men, median disease duration 6 years] diagnosed with CD according to established criteria underwent SBCE in the participating centres for the evaluation of disease extent and mucosal healing or the investigation of clinical relapse or iron deficiency anaemia. Based on ileo-colonoscopy findings disease location was documented in 618 patients (73.65%) as follows: colitis in 219 (26.10%), ileo-colitis in 253 (30.15%), and terminal ileitis in 146 (17.40%) patients; in contrast, full disease location was not documented in 221/839 (26.34%) patients who had colonic involvement but the ileocaecal valve could not be intubated. In the latter group, SBCE revealed small bowel involvement in 96 (43.43%) patients. In addition, SBCE revealed more proximal lesions in 105/618 (16.99%) patients with ileo-colonoscopy documented colitis, ileo-colitis or terminal ileitis. These findings led to a change in therapeutic management in 98 patients (11.68%): 36 patients (4.29%) received biologics, 21 patients (2.50%) received intensified doses of or changed the administered biologic, 39 patients (4.64%) received corticosteroids and/or conventional immunosuppressants and 2 patients (0.23%) underwent surgery. Therapeutic management changes were commoner in patients in whom small bowel lesions were found during SBCE and in whom the terminal ileum had not been examined during colonoscopy (57/96 patients vs. 41/105, p = 0.003]. Capsule retention occurred in 9 patients (1.07%) and passed after administration of corticosteroids (n = 6), or the capsule was retrieved with push enteroscopy (n = 1) or surgery (n = 1). Conclusion SBCE is a valuable tool in the management of patients with established CD, especially in those whom the terminal ileum has not been examined during the preceding colonoscopy.

scholarly journals Examination of Entire Gastrointestinal Tract: A Perspective of Mouth to Anus (M2A) Capsule Endoscopy

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1367
Author(s):  
Ji-Hyung Nam ◽  
Kwang-Hoon Lee ◽  
Yun-Jeong Lim
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Clinical Application ◽  
Capsule Endoscopy ◽  
Diagnostic Tool ◽  
Direct Visualization ◽  
Gi Tract ◽  
Non Invasive ◽  
Technological Advances ◽  
Entire Gastrointestinal Tract

Capsule endoscopy (CE) is the only non-invasive diagnostic tool that enables the direct visualization of the gastrointestinal (GI) tract. Even though CE was initially developed for small-bowel investigation, its clinical application is expanding, and technological advances continue. The final iteration of CE will be a mouth to anus (M2A) capsule that investigates the entire GI tract by the ingestion of a single capsule. This narrative review describes the current developmental status of CE and discusses the possibility of realizing an M2A capsule and what needs to be overcome in the future.

scholarly journals The role of wireless capsule endoscopy in the evaluation of patients with suspected small bowel bleeding: A single center experience

2007 ◽  
Vol 54 (1) ◽  
pp. 25-33 ◽  
Author(s):  
M.N. Krstic ◽  
J. Martinov ◽  
S.N. Krstic ◽  
Dj. Saranovic ◽  
Z.D. Lausevic ◽  
...  
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Diagnostic Tool ◽  
Vascular Lesions ◽  
Gi Bleeding ◽  
Single Center Experience ◽  
Occult Bleeding ◽  
Negative Findings ◽  
Capsule Retention ◽  
One Year

Background: Capsule endoscopy (CE) is a new diagnostic tool for the study of patients with suspected small bowel pathology. The aim of the study was to clarify the usefulness of CE in the group of patients with obscure (overt / occult) gastrointestinal (GI) bleeding. Patients and methods: Thirty patients (14 men, 16 women, mean age 50 years, range 9 -79 years) were enrolled in the study. All of them undergone non-diagnostic esophagogastroduodenoscopy, colonoscopy and barium follow-through of the small bowel. All patients underwent capsule endoscopy. Fourteen patients had overt and sixteen occult bleeding. The single senior endoscopist interpreted CE findings in an unblended manner. Results: CE identified a source of bleeding in 14/30 patients (46,6 %). Lesions identified were: tumors in five pts, vascular lesions, Crohn's disease and Meckel's diverticulum in two pts and fresh bleeding, segmental celiac disease and colonic diverticulosis in one patient each. CE identified a source of bleeding in 9/14 (64,3%) of patients with ongoing overt bleeding and in only 5/16 (31,3%) of patients with occult bleeding. The positive suspicious findings were seen in 6/30 (20%) of patients (2/14 with overt bleeding and 4/16 with occult bleeding. In 3/14 (21,4%) with overt and 7/16 (43,7%) with occult bleeding findings on CE were negative. All patients with negative findings on follow-up remained asymptomatic for one year. Capsule retention because of unsuspected stenosis occurred in a single patient and required surgery, which resolved the problem. Conclusion: CE is an effective diagnostic tool for patients with obscure GI bleeding. It is safe and painless technique which can diagnose the bleeding site beyond the reach of conventional endoscopy. The best candidates for the procedure are those with ongoing and overt bleeding.

NSAID enteropathy detection by small bowel capsule endoscopy

2011 ◽  
Vol 49 (05) ◽  
Author(s):  
V Kovács ◽  
M Szalai ◽  
G Kiss ◽  
H Regőczi ◽  
I Rácz
Keyword(s):  
Small Bowel ◽  
Capsule Endoscopy ◽  
Nsaid Enteropathy
Sign in / Sign up

Export Citation Format

Share Document