Usefulness of patency capsule prior to small-bowel capsule endoscopy in clinical practice: Validity of the modified method of patency judgement

Abstract In 2012, Japan approved the use of a tag-less patency capsule (PC), which evaluates gastrointestinal patency before small-bowel capsule endoscopy (SBCE). This study aimed to evaluate the validity of our modification on the passage criteria for this PC in clinical practice. We retrospectively enrolled 326 consecutive patients who underwent PC examination before SBCE. If X-ray could not reveal the PC in the body during the judgement time (30–33 h after ingestion), we defined it as ‘estimated patency’ and performed SBCE. We employed plain computed tomography (CT) for the second judgement, as needed. The overall patency rate was 95.1%. By X-ray, 41 (12.6%) patients were judged to have ‘estimated patency’, and SBCE could be safely performed. Plain CT judgement was necessary in 32.5%. One PC case had a residual coating film associated with stenosis in a patient with Crohn’s disease (CD), and one (0.3%) SBCE case had capsule retention resulting from false CT judgement. Multivariate analysis revealed that established CD and inpatient were factors related to patency loss. In conclusion, PC is useful for examining gastrointestinal patency, keeping in mind CT misjudgement. If PC was not found in the body via X-ray, performing SBCE as ‘estimated patency’ seemed appropriate.

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VIDEO CAPSULE ENDOSCOPY IN THE SMALL BOWEL DISEASES: LOOKING FOR ITS CORRECT EMPLOYMENT IN CLINICAL PRACTICE

Digestive and Liver Disease ◽

10.1016/s1590-8658(09)60438-2 ◽

2009 ◽

Vol 41 ◽

pp. S166-S167 ◽

Cited By ~ 1

Author(s):

M. Soncini ◽

E. Campi ◽

P. Lanzi ◽

A. Colucci ◽

R. Pometta ◽

...

Keyword(s):

Clinical Practice ◽

Small Bowel ◽

Capsule Endoscopy ◽

Video Capsule Endoscopy ◽

Bowel Diseases ◽

Small Bowel Diseases

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Sa1743 Efficacy of Patency Capsule and Abdominal Xray in Predicting Passage of Video Capsule Endoscopy to the Cecum in Patients Suspected of Potential Capsule Retention

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2012.04.263 ◽

2012 ◽

Vol 75 (4) ◽

pp. AB261

Author(s):

Thomas H. Smith ◽

Achuthan Sourianarayanane ◽

John J. Vargo ◽

Jan Santisi ◽

Cindy Heinlein ◽

...

Keyword(s):

Capsule Endoscopy ◽

Video Capsule Endoscopy ◽

Patency Capsule ◽

Capsule Retention

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Small-Bowel Capsule Endoscopy in Patients with Suspected Crohn's Disease—Diagnostic Value and Complications

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2010/101284 ◽

2010 ◽

Vol 2010 ◽

pp. 1-7 ◽

Cited By ~ 11

Author(s):

Pedro Figueiredo ◽

Nuno Almeida ◽

Sandra Lopes ◽

Gabriela Duque ◽

Paulo Freire ◽

...

Keyword(s):

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Capsule Endoscopy ◽

Inflammatory Markers ◽

Diagnostic Yield ◽

Villous Atrophy ◽

Tertiary Care ◽

Endoscopic Findings ◽

Capsule Retention

Background. The aim of this work was to assess the value of capsule enteroscopy in the diagnosis of patients with suspected Crohn's Disease (CD). Methods. This was a retrospective study in a single tertiary care centre involving patients undergoing capsule enteroscopy for suspected CD. Patients taking nonsteroidal anti inflammatory drugs during the thirty preceding days or with a follow-up period of less than six months were excluded. Results. Seventy eight patients were included. The endoscopic findings included mucosal breaks in 50%, ulcerated stenosis in 5%, and villous atrophy in 4%. The diagnosis of CD was established in 31 patients. The sensitivity, specificity, positive and negative predictive value of the endoscopic findings were 93%, 80%, 77%, and 94%, respectively. Capsule retention occurred in four patients (5%). The presence of ulcerated stenosis was significantly more frequent in patients with positive inflammatory markers. The diagnostic yield of capsule enteroscopy in patients with negative ileoscopy was 56%, with a diagnostic acuity of 93%. Conclusions. Small bowel capsule endoscopy is a safe and valid technique for assessing patients with suspected CD. Capsule retention is more frequent in patients with positive inflammatory markers. Patients with negative ileoscopy and suspected CD should be submitted to capsule enteroscopy.

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Clinical Experience with the PillCam Patency Capsule prior to Video Capsule Endoscopy: A Real-World Experience

Gastroenterology Research and Practice ◽

10.1155/2016/9657053 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 14

Author(s):

C. Römmele ◽

J. Brueckner ◽

H. Messmann ◽

S. K. Gölder

Keyword(s):

Risk Factors ◽

Retrospective Analysis ◽

Clinical Experience ◽

Capsule Endoscopy ◽

Real World ◽

Video Capsule Endoscopy ◽

Radiological Imaging ◽

Patency Capsule ◽

Capsule Retention ◽

Mean Time

Background.In patients with known or suspected risk factors for gastrointestinal stenosis, the PillCam patency capsule (PC) is given before a video capsule endoscopy (VCE) in order to minimize the risk of capsule retention (CR). CR is considered unlikely upon excretion of the PC within 30 hours, excretion in an undamaged state after 30 hours, or radiological projection to the colon.Methods.We performed a retrospective analysis of 38 patients with risk factors for CR, who received a PC from 02/2013 to 04/2015 at Klinikum Augsburg.Results.Sixteen of our 38 patients observed a natural excretion after a mean time of 34 hours past ingestion. However, only 8 patients observed excretion within 30 hours, as recommended by the company. In 20 patients passage of the PC into the colon was shown via RFID-scan or radiological imaging (after 33 and 45 hours, resp.). Only 2 patients showed a pathologic PC result. In consequence, 32 patients received the VCE; no CR was observed.Conclusion.Our data indicates that a VCE could safely be performed even if the PC excretion time is longer than 30 hours and the excreted PC was not screened for damage.

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