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ISSN 1665-2576 (Print)

2003, Number 1

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Rev Mex Cir Endoscop 2003; 4 (1)

Capsule endoscopy

López AME, Mora LJG, Gómez CX, Teramoto MO, Zamarripa DF, González-Angulo RA, Rodríguez VG

Language: Spanish
References: 23
Page: 5-12
PDF size: 93.32 Kb.


ABSTRACT

Background: The need to diagnose clinical entities that are outside the reach of traditional endoscopy led to the development of capsule endoscopy together with the technological advantage make possible to explore gastrointestinal track completely. Objective: Present the initial experience with capsule endoscopy in the diagnostic of clinical entities that are outside of conventional upper endoscopy or colonoscopy. Material and methods: Prospective cases from april 2002 to march 2003, that included patients that come the Endoscopy Unit of the Hospital “Dr. Manuel Gea González” and Gastrointestinal Fisiology Unit of the Hospital “Angeles de Las Lomas” with hematemesis or melena where the radiology exams and conventional endoscopy had failed to identify the bleeding source. We used the GIVEN IMAGING M2A PLUS capsule endoscopy with recovery equipment of images that includes eight sensors that are attached to the body of the patient during the procedure with an average recording time of about 7 hours with a range from 4:43 to 7:45 hours, the data is downloaded to recorder and then into the workstation. A dedicated software rapid reader processes the image data to produce a video. Capsule endoscopy is contraindicated in patients with a cardiac pacemaker, previous abdominal or pelvic radiation, intestinal blockage and bowel perforation. Results: From april 2002 to march 2003 , 25 patients were included. Female sex predominated (56%), age average was 54.5 years with range from 21 to 92 years. All patients completed the study; in 4 patients (16%) the capsule did not reach the ileocecal valve during the recording time. The identified abnormalities included: 5 patients with ulcers in jejunum, 4 active bleeding one with fresh clot in jejunum and the other without a specific lesion, 2 submucosal leiomyomas one of them with ascaris lumbricoides, 5 patients with angiodysplasias in jejunum, one ulcer in ileum, one of them with ileitis and yeyunitis, with improved with restriction diet, 5 normal studies and 3 non satisfactories, this by alimentary rest and error in transmission. Enteroscopy was completed in 3 patients, in which the diagnosis from the capsule was confirmed in one and in 2 cases by surgery. The average time of the capsule in stomach was 25.6 minutes and total transit enteral time was 218.36 minutes. We had no complications attributed to the use of the capsule. EC was usefull in 68% of the cases and a precise diagnostic was in 8. Conclusion: The use of capsule endoscopy is a safe method, non invasive, for the diagnosis of small intestinal disorders, in particular for obscure gastrointestinal bleeding. Is a procedure that appears useful but must continue to be evaluated and probably in future be most indications.


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