Screening of esophageal varices by esophageal capsule endoscopy: results of a French multicenter prospective study

Abstract Background Esophagogastroduodenoscopy (EGD) is the standard method for diagnosis of esophageal and gastric varices in children. In this prospective study we evaluated the use of PillCam esophageal capsule endoscopy (ECE) in pediatric patients. Methods Patients aged 7 to 18 years presenting with portal hypertension and/or cirrhosis underwent ECE (PillCam ESO 2, Given Imaging Ltd.) followed by EGD. Results 102 patients were screened, 81 (52 boys; mean age 13.96 ± 0.25 years) were included and 21 were excluded (16 for “candy test” failure). Esophageal varices were identified by EGD in 62 patients (77 %) and by ECE in 57 patients (70 %) using the de Franchis classification (DFC). The sensitivity of ECE for esophageal varices was 92 % and the specificity was 100 % using DFC. Based upon 57/81 patients with small, medium, and large varices on both ECE and EGD, using DFC, the sensitivity, specificity, positive (PPV) and negative predictive value (NPV) were 55 %, 92 %, 89 %, and 63 %, respectively, giving a total overall accuracy of 72 %. To improve sensitivity and specificity in classification of esophageal varices, we propose using a modified score. This score detected esophageal varices with 100 % sensitivity, 93 % specificity, 94 % PPV, and 100 % NPV, giving a total overall accuracy of 97 %. All patients preferred ECE over EGD. No capsule retention was recorded. Conclusions ECE is a well-tolerated and safe procedure in children. Using the modified score, the sensitivity of ECE is currently sufficient to detect esophageal varices and replace EGD in infants with suspicion of esophageal varices or when EGD is refused.

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Prospective Study Comparing Esophageal Capsule Endoscopy (ECE) vs. Upper Endoscopy (EGD) in the Detection and Grading of Esophageal Varices

The American Journal of Gastroenterology ◽

10.14309/00000434-200609001-00397 ◽

2006 ◽

Vol 101 ◽

pp. S176-S177

Author(s):

Thadis Cox ◽

Alvaro Gonzalez Koch ◽

Antonio Bosch ◽

Razvan Arsenescu ◽

Trevor Winter ◽

...

Keyword(s):

Prospective Study ◽

Capsule Endoscopy ◽

Esophageal Varices ◽

Upper Endoscopy ◽

Esophageal Capsule

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M1123 The Accuracy and Safety of Esophageal Capsule Endoscopy for the Detection of Esophageal Varices: A Meta-Analysis

Gastroenterology ◽

10.1016/s0016-5085(08)61599-1 ◽

2008 ◽

Vol 134 (4) ◽

pp. A-343

Author(s):

Dimple Raina ◽

Thad Wilkins ◽

Sherman Chamberlain ◽

Mark Ebell

Keyword(s):

Capsule Endoscopy ◽

Esophageal Varices ◽

Meta Analysis ◽

Esophageal Capsule

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Esophageal Capsule Endoscopy (PillCam ESO) Is Comparable to Traditional Endoscopy for Detection of Esophageal Varices-An International Multi-Center Trial

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2007.03.017 ◽

2007 ◽

Vol 65 (5) ◽

pp. AB107 ◽

Cited By ~ 3

Author(s):

Roberto De Franchis ◽

Glenn M. Eisen ◽

Abraham R. Eliakim ◽

Amandeep Sahota ◽

Ignacio Fernandez-Urien ◽

...

Keyword(s):

Capsule Endoscopy ◽

Esophageal Varices ◽

Esophageal Capsule

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OC.10.3 SMALL BOWEL CAPSULE ENDOSCOPY (SBCE) IN THE ELDERLY. A MULTICENTER PROSPECTIVE STUDY

Digestive and Liver Disease ◽

10.1016/s1590-8658(13)60213-3 ◽

2013 ◽

Vol 45 ◽

pp. S77-S78

Author(s):

C.M. Girelli ◽

M. Soncini ◽

E. Rondonotti ◽

R. De Franchis ◽

A. Russo ◽

...

Keyword(s):

Small Bowel ◽

Prospective Study ◽

Capsule Endoscopy ◽

The Elderly ◽

Multicenter Prospective Study

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Detachable string magnetically controlled capsule endoscopy for complete viewing of the esophagus and stomach

Endoscopy ◽

10.1055/a-0856-6845 ◽

2019 ◽

Vol 51 (04) ◽

pp. 360-364 ◽

Cited By ~ 6

Author(s):

Yi-Zhi Chen ◽

Jun Pan ◽

Yuan-Yuan Luo ◽

Xi Jiang ◽

Wen-Bin Zou ◽

...

Keyword(s):

Pilot Study ◽

Adverse Events ◽

Diagnostic Accuracy ◽

Reflux Esophagitis ◽

Capsule Endoscopy ◽

Esophageal Varices ◽

Esophageal Disease ◽

Technical Success ◽

Novel Technique ◽

Esophageal Capsule

Abstract Background Esophageal capsule endoscopy is reported to be insufficiently accurate to replace esophagogastroduodenoscopy (EGD) because the passage of the capsule through the esophagus is passive and precludes a thorough investigation. We developed a modified capsule endoscopy technique, called detachable string magnetically controlled capsule endoscopy (DS-MCE), and performed a pilot study to assess the feasibility and safety of this novel technique. Methods 4 healthy volunteers and 21 patients with suspected esophageal disease first underwent DS-MCE followed by EGD within 1 week. Outcomes included technical success of DS-MCE, adverse events, discomfort, and diagnostic accuracy. Results DS-MCE was successfully carried out in all 25 participants. No adverse events were observed. Mean overall discomfort score during DS-MCE was 0.96 (range 0 – 3). DS-MCE diagnoses were in accordance with EGD in all 25 participants. The per-patient sensitivity of DS-MCE for esophageal disease detection was 100 %. The accuracy of DS-MCE for grading esophageal varices and reflux esophagitis were 66.7 % and 100 %, respectively. Conclusions DS-MCE was a feasible, safe, and well-tolerated method for viewing the esophagus and proceeding with gastric examination after string detachment.

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Esophageal Capsule Endoscopy for Screening Esophageal Varices among Japanese Patients with Liver Cirrhosis

Gastroenterology Research and Practice ◽

10.1155/2012/946169 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 7

Author(s):

Haruya Ishiguro ◽

Shoichi Saito ◽

Hiroo Imazu ◽

Hiroyuki Aihara ◽

Tomohiro Kato ◽

...

Keyword(s):

Liver Cirrhosis ◽

High Risk ◽

Capsule Endoscopy ◽

Esophageal Varices ◽

Japanese Patients ◽

Pharmacological Therapy ◽

Asian Countries ◽

Highly Sensitive ◽

Esophageal Capsule ◽

Sensitive Method

Purpose. Although esophageal capsule endoscopy (ECE) is reportedly useful in the diagnosis of esophageal varices (EV), few reports have described the benefits of this technique in Asian countries. The present paper evaluates the usefulness of ECE for diagnosing EV in Japanese patients with cirrhosis.Methods. We examined 29 patients with cirrhosis (20 males and 9 females; mean age 60 years; Child-Pugh classification A/B/C; 14/14/1) using ECE followed by esophagogastroduodenoscopy (EGD). High-risk EV were defined as F2 and/or RC2 and above.Results. The sensitivity and specificity of ECE for the diagnosis of high-risk EV were 92% and 80%, respectively.Conclusions. The findings showed that ECE is a highly sensitive method of diagnosing high-risk EV that requires endoscopic or pharmacological therapy. Thus, ECE might be a useful method for the screening and followup of EV in patients with cirrhosis.

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