A pilot study of capsule endoscopy after a standard meal for the detection and grading of oesophageal varices in cirrhotic patients |
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Authors: | Brigida Eleonora Annicchiarico Maria Elena Riccioni Massimo Siciliano Riccardo Urgesi Cristiano Spada Gianluigi Caracciolo Antonio Gasbarrini Guido Costamagna |
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Affiliation: | 1. Department of Internal Medicine, Catholic University of Sacred Heart, Rome, Italy;2. Digestive Endoscopy Unit, Catholic University of Sacred Heart, Rome, Italy;3. Gastroenterology and Digestive Endoscopy Unit, Ospedale Belcolle, Viterbo, Italy |
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Abstract: | BackgroundCapsule endoscopy has been proposed as an alternative to fibreoptic endoscopy for oesophageal varices evaluation in cirrhotics. However, it shows only moderate sensitivity compared to fibreoptic endoscopy.AimTo compare post-meal capsule endoscopy to fibreoptic endoscopy, based on the hypothesis that meal-induced increase of portal pressure can enhance its sensitivity.MethodsTwenty-five patients were submitted to fibreoptic endoscopy and, after a standard meal, capsule endoscopy.ResultsPost-meal capsule endoscopy detected varices in the 18 patients in whom fibreoptic endoscopy detected varices plus 3 more subjects (sensitivity 100%, specificity 70%); large varices in the 4 patients in whom fibreoptic endoscopy graded varices as large, plus 5 more subjects; red markers in the 5 patients in whom fibreoptic endoscopy detected red markers, plus 3 more subjects. High-risk varices were identified in 11 patients by post-meal capsule endoscopy and in 10 by fibreoptic endoscopy (sensitivity 100%, specificity 93.8%).ConclusionsPost-meal capsule endoscopy identified more varices, large varices and red markers than fibreoptic endoscopy. The two methods detected similar proportions of high-risk varices. These data suggest that a standard meal can enhance the sensitivity of capsule endoscopy in the detection and grading of oesophageal varices in cirrhotics. |
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Keywords: | Capsule endoscopy Oesophageal varices Portal hypertension |
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