Derzeitige Bewertung der Kapselendoskopie in der Diagnostik von Dünndarmerkrankungen

Die Kapselendoskopie (KE) bedient sich einer 26 × 11 mm großen plastiküberzogenen Kapsel mit eingebauter Kamera, die für etwa 6 - 10 Stunden Bilder aufnimmt, die auf einen Datenrekorder gesendet werden; diese Daten werden aufgezeichnet und nach Beendigung der Aufnahmezeit auf einen PC überspielt, wo sie anschließend innerhalb von 2 - 3 Stunden ausgewertet werden können. Hierbei wird zur Beurteilung des Dünndarms die Zeit zwischen Pylorus und Valvula Bauhini/Zökum ausgewertet. Die Datenlage besteht derzeit aus einer initialen Kommunikation in der Zeitschrift „Nature” [1], einer tierexperimentellen Studie [2], mehreren klinischen peerreviewten Originalarbeiten über Dünndarmblutungen [3 9], Morbus Crohn [10 12] und gemischte Indikationen [13 18] und einer kleinen Studie über Patienten mit Bauchschmerzen [19] sowie einer Fallserie im Deutschen Ärzteblatt [20]. Eine weitere Arbeit beschäftigt sich mit dem Ösophagus [21]. Somit hat sich seit dem ersten Positionspapier die Datenlage verbessert. Einbezogen werden auch die zahlreichen Abstracts großer Kongresse wie DDW, UEGW und DGVS von 2002 und 2003 (Zitate im Einzelnen im Text). Die zunehmenden Fallberichte [22 34] werden nur in Einzelfällen herangezogen.

Literatur

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• 116 Bolz G, Schmitt H, Hartmann D. et al . Prospective controlled multicentric trial comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with chronic gastrointestinal bleeding.  Endoscopy. 2003;  35 (Suppl II) A5 (abstract)
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• 119 Saurin J C, Delvaux M, Gaudin J L. et al . Clinical impact of small-bowel examination by wireless video capsule (WVC) compared to push-enteroscopy (PE) in obscure digestive bleeding: One-year follow-up study.  Gastrointest Endosc. 2003;  57 AB84 (abstract)
• 120 Chong A, Taylor A, Miller A. et al . Clinical outcomes following capsule endoscopy (CE) examination of patients with obscure gastrointestinal bleeding (OGB).  Gastrointest Endosc. 2003;  57 AB166 (abstract)
• 121 Jensen D M, Dulai G, Kovacs T OG. et al . A Gold standard for diagnosis of very severe GI bleeding of obscure etiology.  Gastrointest Endosc. 2003;  57 AB166 (abstract)
• 122 Cauendo A, Rodríguez-Téllez M, Romero J. et al . Capsule endoscopy (CE) in patients with iron deficiency anemia (IDA).  Endoscopy. 2003;  35 (Suppl II) A183 (abstract)
• 123 Tabibzadeh S, Zaidel O, Papadakis K. et al . Utility of wireless capsule enteroscopy (WCE) versus serology in the evaluation of small bowel Crohn’s disease.  Gastrointest Endosc. 2003;  57 AB171 (abstract)
• 124 Eliakim R, Suissa A, Yassin K. et al . Wireless capsule video endoscopy (CE) vs. barium follow through (SBFT) and computerized tomography (CT) in patients with suspected Crohn’s disease (CD) - Final report.  Gut. 2003;  52 (Suppl VI) A106 (abstract)
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• 140 Piqueras J P, Payeras G, Saez M A. et al . Wireless capsule endoscopy for the detection of gastrointestinal lesions in active AIDS patients.  Endoscopy. 2002;  34 (Suppl II) A91 (abstract)
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16 * Bezeichnung der Evidenzgrade nach: Preventive Service Task Force. Guide to clinical preventive services: Report of the US Preventive Service Task Force. 2^nd edition. Baltimore: Williams and Wilkins, 1996