摘要
Background and Study Aims: The small bowel is anatomically difficult to examin e; disease conditions are rarely located in it, but can be serious. Neither conv entional radiography nor push enteroscopy has sufficient sensitivity and specifi city to detect distinct lesions. Wireless capsule endoscopy can theoretically al low imaging of the entire small bowel, with only minimal discomfort for the pati ent. Patients and Methods: Between November 2001 and May 2003, 191 patients rece ived 195 capsules. Data were collected retrospectively from consecutive patients in three centers. The indications for capsule endoscopy were obscure or occult bleeding, suspected Crohn’s disease, or other reasons in 151, 25, and 15 patien ts, respectively. The clinical outcome after 6 months was evaluated on the basis of interviews with patients or relatives. Results: Visualization of the entire small bowel was adequate in 78.4%of the examinations. The colon was not reached in 16.9%of cases, and there were minor technical problems in 4.6%. Relevant p athological findings were identified in 56.2%of 151 patients with obscure bleed ing or iron-deficiency anemia (64%of whom received blood transfusions). The mo st common findings were angiodysplasia in 39.7%of cases and ulcers of the small bowel in 7.3%. In addition, individual cases of tumors and parasitic worms wer e detected. Seven of the 25 patients with suspected Crohn’s disease (28%) had the disease confirmed. Three of five patients with polyposis syndrome of the col on were found to have polyps in the small bowel. Conclusions: Wireless capsule e ndoscopy can be recommended as part of the routine work-up in patients with obs cure bleeding or iron-deficiency anemia. In patients with Crohn’s disease, the method may be helpful in establishing or ruling out the diagnosis.
Background and Study Aims: The small bowel is anatomically difficult to examin e; disease conditions are rarely located in it, but can be serious. Neither conv entional radiography nor push enteroscopy has sufficient sensitivity and specifi city to detect distinct lesions. Wireless capsule endoscopy can theoretically al low imaging of the entire small bowel, with only minimal discomfort for the pati ent. Patients and Methods: Between November 2001 and May 2003, 191 patients rece ived 195 capsules. Data were collected retrospectively from consecutive patients in three centers. The indications for capsule endoscopy were obscure or occult bleeding, suspected Crohn's disease, or other reasons in 151, 25, and 15 patien ts, respectively. The clinical outcome after 6 months was evaluated on the basis of interviews with patients or relatives. Results: Visualization of the entire small bowel was adequate in 78.4%of the examinations. The colon was not reached in 16.9%of cases, and there were minor technical problems in 4.6%. Relevant p athological findings were identified in 56.2%of 151 patients with obscure bleed ing or iron-deficiency anemia (64%of whom received blood transfusions). The mo st common findings were angiodysplasia in 39.7%of cases and ulcers of the small bowel in 7.3%. In addition, individual cases of tumors and parasitic worms wer e detected. Seven of the 25 patients with suspected Crohn's disease (28%) had the disease confirmed. Three of five patients with polyposis syndrome of the col on were found to have polyps in the small bowel. Conclusions: Wireless capsule e ndoscopy can be recommended as part of the routine work-up in patients with obs cure bleeding or iron-deficiency anemia. In patients with Crohn's disease, the method may be helpful in establishing or ruling out the diagnosis.
