Clinical outcome of patients examined by capsule endoscopy for suspected small bowel Crohn''s disease

BACKGROUND: Capsule endoscopy has a greater diagnostic yield than radiology for detecting subtle inflammatory changes of the small bowel mucosa, but the clinical significance of these abnormalities is still uncertain because of the lack of long-term follow-ups. AIM AND METHODS: To verify the accuracy of capsule endoscopy in a cohort of patients with suspected Crohn's disease of the small bowel, taking as 'gold standard' the final diagnosis made after a long follow-up. From April 2002 to March 2005, we enrolled and examined by capsule endoscopy 27 consecutive patients with abdominal pain and diarrhea lasting more than 3 months and at least one of the following: anaemia, weight loss, fever, extra-intestinal manifestation(s) of inflammatory bowel disease. All patients already had an unremarkable pan-endoscopy, serology for celiac disease and intestinal radiology inconclusive for small bowel abnormality. On the basis of capsule endoscopy findings, patients were distributed in three groups; Group A had severe stricturing lesions requiring surgery; Group B, moderate inflammatory lesions further investigated invasively; Group C, minimal inflammatory changes or normal findings, clinically observed every 3 months (median 21 months, range 15-29). RESULTS: Small bowel inflammatory lesions were found in 16 of the 27 patients (diagnostic yield 59%). Three had surgery (Group A) and Crohn's disease was confirmed in two; the remainder had ileal adenocarcinoma in a pathological context of chronic inflammation. Crohn's disease was histologically confirmed in four of the five patients in Group B. Group C comprised 19 patients; Crohn's disease was confirmed in seven out of eight with positive capsule endoscopy, while only one of the patients with normal findings later developed overt ileal Crohn's disease. Sensitivity, specificity, positive and negative likelihood ratio were, respectively, 93%, 84%, 5.8 and 0.08. Assuming a 50% pre-test probability of disease, capsule endoscopy gave a post-test probability of 85%. CONCLUSIONS: In our selected cohort, capsule endoscopy was highly sensitive in detecting small bowel inflammatory changes, enhancing by nearly 35% the pre-test probability of structural small bowel disease. Focal erythema and luminal debris may limit the specificity of capsule endoscopy.     

Bowel preparation for small bowel capsule endoscopy – The later,the better!

BackgroundIn small bowel capsule endoscopy (SBCE), the presence of residue may compromise diagnostic accuracy.AimsTo assess differences in quality of visualisation and diagnostic yield of SBCE using 3 different preparation protocols.MethodsProspective, randomized, blind, pilot study. Protocol A:Clear liquids diet the day before the examination with fasting from 8p.m.; Protocol B:Protocol A + 2 pouches of Moviprep^®(polyethylene glycol electrolyte solution + sodium ascorbate) in 1 L of water from 8p.m. of the day before the examination; Protocol C: Protocol A + 2 pouches of Moviprep^® in 1 L of water consumed after real-time confirmation of capsule arrival at small bowel.Small bowel preparation was classified by two experienced physicians, considering the percentage of the examination during which mucosal observation was adequate: Excellent(>90%); Good(90–75%); Fair(75–50%); Poor(<50%).Results101 patients randomized to the 3 protocols (A 37, B 31, C 33 patients). Protocol C had an excellent/good small bowel preparation in a higher percentage of examinations for both readers(Reader 1-A:37.8% vs B:45.2% vs C:78.8%, p = 0.002 and Reader 2 –A:37.8% vs B:41.9% vs C:75.8%, p = 0.003). Also, protocol C had a higher detection of angioectasia (A:5.4% vs B:9.7% vs C:27.3%, p = 0.022).ConclusionsThe administration of Moviprep^® after the capsule had reached the small bowel was associated with a better small bowel preparation and a higher detection of angioectasia.     

Improved capsule endoscopy after bowel preparation

BACKGROUND: The diagnostic yield of capsule endoscopy depends on the quality of visualization of the small-bowel wall and complete passage through the small bowel. This study examined the effect of bowel preparation on the volume of intestinal content and on small-bowel transit. METHODS: Sixty-one consecutive patients (34 men, 27 women; mean age 56 years, range 17-88 years) were enrolled in the study. Although not randomized, 33 patients received a bowel preparation, and 28 had no preparation. Gastric emptying, small-bowel transit time, overall preparation assessment, and bowel-wall visualization were evaluated by 3 investigators who were unaware of whether the patient had undergone bowel preparation. RESULTS: Small-bowel transit time was significantly shorter in patients with bowel preparation (median 213 minutes: 95% CI[190, 267]) than in those without preparation (median 253 minutes: 95% CI[228, 307]) (p <0.01). The capsule reached the cecum in 97% of patients in the bowel-preparation group, compared with 76% in the nonpreparation group (p=0.02). Bowel preparation improved the quality of visualization significantly; this effect was more pronounced in the distal small bowel. CONCLUSIONS: This study demonstrated that bowel preparation accelerates small-bowel capsule transit and leads to a higher rate of complete capsule endoscopy. Visualization of the small bowel was improved by bowel preparation. Bowel preparation before capsule endoscopy is recommended.     

Is a 2-liter PEG preparation useful before capsule endoscopy?

AIMS: Small bowel contents can sometimes hamper the quality of capsule images. Our aim was to investigate the effect of PEG administered prior to capsule endoscopy (CE) upon quality of images, gastrointestinal transit time, and detection rate of small bowel bleeding lesions in patients with obscure gastrointestinal bleeding. PATIENTS AND METHODS: Forty-two consecutive patients were included. CE was performed following a 12-hour fasting period. The 16 first patients (Group A) received no preparation and the following 27 patients (Group B) received 2 L of PEG the night before. The quality of images was assessed at both in duodenojejunum and ileum level, using a scale including the presence of air bubbles, biliary secretion, and residue (1-4). RESULTS: Quality of images were not different in Group A compared with Group B in the duodenojejunum and in the ileum. Gastric transit time tended to be shorter in Group A compared with Group B (25.5 vs. 45.7 minutes) (P = 0.15), whereas small bowel transit was not different between both groups (271 vs. 288 minutes). Total small bowel CE examination was complete in Group A and in 24 of 26 in Group B (not significant). Potential bleeding lesions were seen in 8 patients in Group A and 12 in Group B (not significant). CONCLUSION: Our retrospective study suggests that 2 L PEG preparation seems able to improve neither the quality of CE images nor its diagnostic performance. Moreover, in our study, PEG tended to increase gastric emptying time and may constitute a limitation for small bowel complete examination.     

Capsule endoscopy findings in patients with suspected Crohn''s disease and biochemical markers of inflammation

BACKGROUND: Because it provides a direct view of superficial lesions in the small bowel, capsule endoscopy is a promising diagnostic tool for studying patients with suspected Crohn's disease undetected by conventional modalities. AIM: To assess the role of capsule endoscopy in the diagnosis of patients with suspected Crohn's disease. PATIENTS AND METHODS: Thirty-eight patients (16 males, mean age 46.2 years) with suspected Crohn's disease but negative at conventional imaging were examined using capsule endoscopy. They were divided into 2 groups: 12 patients with ongoing symptoms (Group 1), and 26 with ongoing symptoms and biochemical markers of inflammation (Group 2). Capsule endoscopy findings were classified as diagnostic (multiple erosions/ulcerations), suspicious (相似文献   

Fields of applications,diagnostic yields and findings of OMOM capsule endoscopy in 2400 Chinese patients

AIM:To retrospectively analyze the fields of application,diagnostic yields and findings of OMOM capsule endoscopy in Chinese patients.METHODS:A database including 2400 Chinese patients who received OMOM capsule endoscopy in 27 endoscopy centers in China was retrieved from the Jianshan Science and Technology Ltd.OMOM capsule endoscopy database.The patient's age,gender,fields of application,the potentially relevant findings,pyloric transit time(PTT),small bowel transit time(SBTT),and complete small-bowel exam...     

Effect of erythromycin on image quality and transit time of capsule endoscopy： A two-center study

AIM： To compare the effect of oral erythromycin vs no preparation with prokinetics on the transit time and the image quality of capsule endoscopy （CE） in evaluating small bowel （SB） pathology. METHODS： We conducted a retrospective, blinded （to the type of preparation） review of 100 CE studies, 50 with no preparation with prokinetics from one medical center （Group A） and 50 from another center with administration of a single dose of 200 mg oral erythromycin 1 h prior to CE （Group B）. Gastric, SB and total transit times were calculated, the presence of bile in the duodenum was scored, as was cleanliness within the proximal, middle and distal intestine. RESULTS： The erythromycin group had a slightly shorter gastric transit time （21 min vs 28 min, with no statistical significance）. SB transit time was similar for both groups （all P 〉 0.05）. Total transit time was almost identical in both groups. The rate of incomplete examination was 16% for Group A and 10% for Group B （P = 0.37）. Bile and cleanliness scores in different parts of the intestine were similar for the two groups （P 〉 0.05）. CONCLUSION： Preparation for capsule endoscopy with erythromycin does not affect SB or total transit time. It tends to reduce gastric transit time, but it does not increase the cecum-reaching rate. Erythromycin does not adversely affect image quality. We consider the routine use of oral erythromycin preparation as being unjustified, although it might be considered in patients with known prolonged gastric emptying time.     

New reduced volume preparation regimen in colon capsule endoscopy

AIM: To evaluate the effectiveness of our proposed bowel preparation method for colon capsule endoscopy.METHODS: A pilot, multicenter, randomized controlled trial compared our proposed “reduced volume method” (group A) with the “conventional volume method” (group B) preparation regimens. Group A did not drink polyethylene glycol electrolyte lavage solution (PEG-ELS) the day before the capsule procedure, while group B drank 2 L. During the procedure day, groups A and B drank 2 L and 1 L of PEG-ELS, respectively, and swallowed the colon capsule (PillCam COLON^® capsule). Two hours later the first booster of 100 g magnesium citrate mixed with 900 mL water was administered to both groups, and the second booster was administered six hours post capsule ingestion as long as the capsule had not been excreted by that time. Capsule videos were reviewed for grading of cleansing level.RESULTS: Sixty-four subjects were enrolled, with results from 60 analyzed. Groups A and B included 31 and 29 subjects, respectively. Twenty-nine (94%) subjects in group A and 25 (86%) subjects in group B had adequate bowel preparation (ns). Twenty-two (71%) of the 31 subjects in group A excreted the capsule within its battery life compared to 16 (55%) of the 29 subjects in group B (ns). Of the remaining 22 subjects whose capsules were not excreted within the battery life, all of the capsules reached the left side colon before they stopped functioning. A single adverse event was reported in one subject who had mild symptoms of nausea and vomiting one hour after starting to drink PEG-ELS, due to ingesting the PEG-ELS faster than recommended.CONCLUSION: Our proposed reduced volume bowel preparation method for colon capsule without PEG-ELS during the days before the procedure was as effective as the conventional volume method.     

Diagnostic yield and clinical outcomes of capsule endoscopy

BACKGROUND: Capsule endoscopy is proving to be superior to push enteroscopy and barium contrast radiography for evaluation of the small bowel. However, its impact on clinical outcome has not been thoroughly investigated. This study assessed changes in therapy based on capsule endoscopy findings and on the impact of such changes on patient outcomes. METHODS: Forty-four consecutive capsule endoscopies in 43 patients were reviewed. Data were collected by systematic review of patient records and included indication, results of prior diagnostic tests, and capsule endoscopy findings. Specific interventions after capsule endoscopy and clinical outcome were noted. RESULTS: The indication for capsule endoscopy was obscure GI bleeding in 40 patients, iron deficiency anemia in one, and right lower quadrant abdominal pain in two patients. Overall diagnostic yield was 42% (18/43 patients). Diagnostic findings included angiodysplasias (n = 13), intestinal ulcers (n = 2), Crohn's disease (n = 2), and mass lesion (n = 1). As a result of the capsule endoscopy findings, a specific intervention was implemented in 12 of 18 patients with positive findings. These included endoscopy with coagulation (n = 5), laparotomy (n = 2), pharmacotherapy (n = 4), and discontinuation of medication (n = 1). At a mean follow-up of 6.7 months, the clinical outcome was considered positive in 7 of 43 patients (16%). CONCLUSIONS: Although it has a high diagnostic yield, capsule endoscopy has a positive influence on clinical outcome in a relatively small proportion of patients. Larger studies are needed that assess the influence of capsule endoscopy on clinical outcomes.     

Cápsula endoscópica para el estudio de patologías de intestino delgado: experiencia en una institución privada en México

Introduction and aimsCapsule endoscopy has revolutionized the study of small bowel disorders. Its diagnostic yield, reasons for referral, and frequency of significant endoscopic findings at our institution are unknown. The aims of our study were to describe the reasons for referral, the frequency of significant endoscopic findings, and the diagnostic yield of capsule endoscopy in patients that underwent the procedure for the study of small bowel disorders.Material and methodsA retrospective study was conducted that included all patients that underwent capsule endoscopy for small bowel disorder evaluation at our institution. The diagnostic yield for significant endoscopic findings, the frequency of significant endoscopic findings, and the reasons for referral for capsule endoscopy were determined.ResultsA total of 134 patients were included in the study and 143 capsule endoscopies were performed. Women made up 48.5% of the sample and the mean patient age was 63 years (18.7 standard deviation). The main reasons for referral were suspicion of overt small bowel bleeding (55.9%) and suspicion of occult small bowel bleeding (28.6%). The overall diagnostic yield was 66.4%. The most common significant findings were small bowel angioectasias (52.6%) and small bowel ulcers (38.9%). There were two adverse events (1.3%): one capsule retention that required enteroscopic removal and one asymptomatic bronchoaspiration of the capsule that resolved spontaneously.ConclusionsThe frequency of significant endoscopic findings with capsule endoscopy at our institution was different from that reported in other Mexican studies, but the reasons for referral and the diagnostic yield were similar.     

A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease

BACKGROUND & AIMS: This study was undertaken to prospectively compare the clinical outcomes of small bowel radiographs with the wireless capsule endoscopy. METHODS: Twenty-two patients were selected consecutively because of suspected small bowel disease. Two patients were excluded owing to ileal stenosis. Thus, the results of barium follow-through and the Given M2A wireless video capsule (Given Imaging Ltd., Yoqneam, Israel) endoscopy were compared in 20 patients (13 men; mean age, 52.5 yr; range, 29-78 yr). RESULTS: Barium follow-through was normal in 17 patients and showed ileal nodularity in 3 patients. Capsule endoscopy was normal in 3 patients and showed positive findings in the remaining 17 patients. The barium study was considered diagnostic in 4 (20%) patients. The capsule endoscopy was considered diagnostic in 9 (45%) patients, suspicious in 8 (40%) patients, and failed in 3 (15%) patients. For obscure gastrointestinal (GI) bleeding, the diagnostic potential of barium follow-through was much worse as compared with the capsule endoscopy (5% vs. 31%, P < 0.05). Capsule endoscopy was well tolerated and better accepted by patients when compared with the most recently performed endoscopic procedure. CONCLUSIONS: The video capsule endoscope was found to be superior to small bowel radiograph for evaluation of small bowel diseases. However, this novel wireless endoscope system needs further assessment because of limitations such as difficulties in interpretation of potentially nonspecific findings.     

Evaluation of Different Bowel Preparations for Small Bowel Capsule Endoscopy: A Prospective, Randomized, Controlled Study

Background and Study Aims

To obtain an adequate view of the whole small intestine during capsule endoscopy (CE) a clear liquid diet and overnight fasting is recommended. However, intestinal content can hamper vision in spite of these measures. Our aim was to evaluate tolerance and degree of intestinal cleanliness during CE following three types of bowel preparation.

Patients and Methods

This was a prospective, multicenter, randomized, controlled study. Two-hundred ninety-one patients underwent one of the following preparations: 4 L of clear liquids (CL) (group A; 92 patients); 90 mL of aqueous sodium phosphate (group B; 89 patients); or 4 L of a polyethylene glycol electrolyte solution (group C; 92 patients). The degree of cleanliness of the small bowel was classified by blinded examiners according to four categories (excellent, good, fair or poor). The degree of patient satisfaction, gastric and small bowel transit times, and diagnostic yield were measured.

Results

The degree of cleanliness did not differ significantly between the groups (P = 0.496). Interobserver concordance was fair (k = 0.38). No significant differences were detected between the diagnostic yields of the CE (P = 0.601). Gastric transit time was 35.7 ± 3.7 min (group A), 46.1 ± 8.6 min (group B) and 34.6 ± 5.0 min (group C) (P = 0.417). Small-intestinal transit time was 276.9 ± 10.7 min (group A), 249.7 ± 13.1 min (group B) and 245.6 ± 11.6 min (group C) (P = 0.120). CL was the best tolerated preparation. Compliance with the bowel preparation regimen was lowest in group C (P = 0.008).

Conclusions

A clear liquid diet and overnight fasting is sufficient to achieve an adequate level of cleanliness and is better tolerated by patients than other forms of preparation.     

双气囊小肠镜与胶囊内镜诊断小肠出血病因比较

目的比较双气囊小肠镜和胶囊内镜在小肠出血中的诊断准确率和实用价值。方法24例原因不明的可疑小肠出血患者分别接受双气囊小肠镜和胶囊内镜检查。双气囊小肠镜首选进镜方式分为经口或经肛2种，首选方式检查后未发现病灶者，日后改换进镜方式再行检查。胶囊内镜采用以色列GIVEN公司产品。2种检查方法分别由专门医师独立操作并诊断，最后进行汇总比较。结果24例患者中21例通过小肠镜检查发现病灶，总检出率为87．5％。24例患者行胶囊内镜检查后，有阳性发现者11例(45．8％)，另13例无异常发现。双气囊小肠镜检查发现的阳性病灶均经活检病理和手术探查证实，其病因诊断准确率为87．5％，胶囊内镜诊断准确率为25％。在耐受性评估方面，胶囊内镜和全麻下经口进镜的耐受性最佳，以后依次为非麻醉经肛方式和非麻醉经口方式。所有小肠镜和胶囊内镜检查者中未见操作相关的严重不良反应。结论①经口和经肛方式结合能使双气囊小肠镜完成对全小肠的检查。②双气囊小肠镜在不明原因小肠出血的病因诊断方面明显优于胶囊内镜检查。③胶囊内镜在小肠多节段病变和长段病变的诊断上仍有一定价值。④胶囊内镜和全麻下经口双气囊小肠镜检查是一项易为患者接受的、安全的检查方法。     

二甲硅油散在胶囊内镜检查术前准备中的作用研究

目的观察二甲硅油散在胶囊内镜检查前对肠腔清洁度的影响及不良反应。方法60例例接受胶囊内镜检查患者随机分为二甲硅油散组（常规服用聚乙二醇电解质散剂的基础上，检查前30min口服二甲硅油散）和对照组（仅服用聚乙二醇电解质散剂），将每例胶囊所获得的小肠图像资料按照小肠通过时间平均分成A、B、C三段，由2位读片者分别根据肠腔内的气泡进行分级。并观察有无不良反应。结果2位读片者间一致性较佳（P〈0．05）。在小肠的A段及C段中，二甲硅油散组较对照组有明显祛泡作用，大大提高的肠黏膜观察清晰度，差异有统计学意义（P〈0．05）。而在B段中，二甲硅油散组与对照组相比差异无统计学意义（P〉0．05）。结论胶囊内镜检查前服用二甲硅油散能提高小肠肠黏膜观察清晰度，无不良反应发生。     

胶囊内镜在小肠疾病诊断中的作用

目的:小肠疾病很难诊断,现有的诊断技术又不尽如人意,而胶囊内镜能发现整个小肠内的微小病变。为此,我们对胶囊内镜在小肠疾病诊断中的价值进行评估。方法:自2002年5月至2003年9月,我们对经结肠镜、胃镜、X线钡餐造影、小肠钡灌造影、血管造影或核素扫描等检查未发现异常的79例疑患小肠疾病、尤其是不明原因消化道出血的患者,进行胶囊内镜检查,其中不明原因的消化道出血患者56例。结果:75例完成最终研究。75例患者中经胶囊内镜检查共发现异常63例,检出率为84％;其中能明确解释临床病因者50例,诊断率为66.6％,包括消化道血管病变21例、小肠炎症性肠病16例、小肠息肉5例、小肠恶性间质肿瘤2例、小肠类癌1例(该患者同时伴升结肠脂肪瘤)、淋巴瘤1例、粘膜下肿瘤3例及憩室1例。所获取的图像质量良好。结论:胶囊内镜对小肠疾病尤其是不明原因消化道出血具有良好的诊断价值。     

Capsule endoscopy in diagnosis of small bowel Crohn′s disease

AIM: To evaluate the effectiveness of wireless capsule endoscopy in patients with suspected Crohn′s disease (CD)of the small bowel undetected by conventional modalities,and to determine the diagnostic yield of M2A Given Capsule.METHODS: From lay 2002 to April 2003, we prospectively examined 20 patients with suspected CD by capsule endoscopy. The patients had the following features:abdominal pain, weight loss, positive fecal occult blood test, iron deficiency anaemia, diarrhoea and fever. All the patients had normal results in small bowel series (SBS)and in upper and lower gastrointestinal endoscopy before they were examined. Mean duration of symptoms before diagnosis was 6.5 years.RESULTS: Of the 20 patients, 13 (65%) were diagnosed as CD of the small bowel according to the findings of M2A Given Capsule. The findings detected by the capsule were mucosal erosions (2 patients), aphthas (5 patients),nodularity (1 patient), large ulcers (2 patients), and ulcerated stenosis (3 patients). The distribution of the lesions was mainly in the distal part of the small bowel,and the mild degree of lesions was 54%.CONCLUSION: Wireless capsule endoscopy is effective in diagnosing patients with suspected CD undetected by conventional diagnostic methods. It can be used to detect early lesions in the small bowel of patients with CD.     

Capsule endoscopy in diagnosis of small bowel Crohn＇s disease

AIM: To evaluate the effectiveness of wireless capsule endoscopy in patients with suspected Crohn‘s disease (CD) of the small bowel undetected by conventional modalities,and to determine the diagnostic yield of M2A Given Capsule.METHODS: From May 2002 to April 2003, we prospectively examined 20 patients with suspected CD by capsule endoscopy. The patients had the following features:abdominal pain, weight loss, positive fecal occult blood test, iron deficiency anaemia, diarrhoea and fever. All the patients had normal results in small bowel series (SBS) and in upper and lower gastrointestinal endoscopy beforethey were examined. Mean duration of symptoms before diagnosis was 6.5 years.RESULTS: Of the 20 patients, 13 (65%) were diagnosed as CD of the small bowel according to the findings of M2A Given Capsule. The findings detected by the capsule were mucosal erosions (2 patients), aphthas (5 patients),nodularity (1 patient), large ulcers (2 patients), and ulcerated stenosis (3 patients). The distribution of the lesions was mainly in the distal part of the small bowel,and the mild degree of lesions was 54%.CONCLUSION: Wireless capsule endoscopy is effective in diagnosing patients with suspected CD undetected by conventional diagnostic methods. It can be used to detect early lesions in the small bowel of patients with CD.     

Capsule endoscopy in clinical routine in patients with suspected disease of the small intestine: a 2-year prospective study

OBJECTIVE: Capsule endoscopy is a promising method for examining the small intestine. The study was performed to evaluate the use of capsule endoscopy in clinical routine in patients with suspected disease of the small intestine. MATERIAL AND METHODS: Consecutive patients with clinically suspected disease of the small intestine referred for capsule endoscopy between 1 January 2003 and 31 December 2004 were included in the study. All patients had previously completed a conventional diagnostic work-up with upper and lower endoscopy as well as abdominal CT scan or small-bowel enteroclysis. RESULTS: A total of 167 patients were referred during the time period and 195 procedures were performed. Seventeen (8.7%) of the procedures were unsuccessful, with no visualization of the small bowel. In the remaining procedures the caecum was reached in 83%. The reason for referral was gastrointestinal bleeding (30%), iron-deficiency anaemia (25%), abdominal pain (15%), diarrhoea (13%) and Crohn's disease (12%). Pathology was found in 27% of the patients, with the highest diagnostic yield in patients referred for Crohn's disease (60%) and the lowest yield (4%) in patients referred for abdominal pain. There were no complications, with the exception of one patient referred for Crohn's disease who had transient abdominal pain during the procedure. CONCLUSIONS: Capsule endoscopy is a safe and well-tolerated procedure. In unselected patients with clinically suspected disease of the small intestine, the procedure gives additional information to conventional diagnostic procedures in 27% of patients. Incomplete examination of the small intestine was frequent in our group of patients.     

Diagnostic yield and clinical outcomes after capsule endoscopy in 100 consecutive patients with obscure gastrointestinal bleeding

OBJECTIVES: The endoscopic capsule is a useful tool for visualizing the small bowel in patients with obscure gastrointestinal bleeding. In this study the authors evaluated the diagnostic aid provided by the endoscopic capsule, the factors predicting a significant finding and their impact on the patients' clinical evolution. METHODS: A total of 100 patients (52 men and 48 women, average age 64.4 years) underwent capsule endoscopy. Of this group, 52 patients presented with obscure-overt bleeding and 48 with obscure-occult bleeding. After an average follow-up time of 11.4 months, the clinical outcome was evaluated in 95 patients. RESULTS: The endoscopic capsule identified significant findings in 68% of patients. The most common diagnosis (33.8%) was angiodysplasias. The most important factor predicting significant findings was the previous need for transfusion in the overt bleeding group. As the result of the findings, a specific intervention was made in 75.8% of patients. At the end of follow-up, the clinical outcome was considered positive in 71.6% of patients. Capsule retention occurred in one patient, who required surgery. CONCLUSION: In patients with obscure gastrointestinal bleeding, capsule endoscopy provides a high degree of diagnostic aid. The best candidates for this procedure are patients with obscure-overt bleeding who have required blood transfusions. Capsule endoscopy has a positive influence on an important proportion of patients, whether oriented towards new diagnostic techniques or towards a definitive treatment.     

提高胶囊内镜检查质量的补救方法研究

目的胶囊内镜检查时,部分患者胶囊进入小肠后发现肠道清洁度较差,本研究拟通过采取补救清肠法,以期提高胶囊内镜检查的成功率及肠道清洁度。方法 90例患者随机分为A组(100 mL甘露醇+200 mL温水)、B组(50 mL甘露醇+100 mL温水)和C组(100 mL温水)3组,比较患者采取补救措施后全小肠检查完成率及肠道清洁度。结果 A组和B组的患者肠道清洁度明显优于C组,A、B两组患者肠道清洁度与C组比较,差异有统计学意义(P<0.05)。全小肠检查率A组为100%(30/30),B组为90%(27/30),C组70%(21/30)。结论采用50 mL甘露醇+100 mL温水进行补救清肠的方法,肠道清洁度好,全小肠检查完成率高,是较为理想的补救清肠方法。