Endoscopy 2007; 39(12): 1041-1045
DOI: 10.1055/s-2007-966943
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Diagnosis of small-bowel pathology using paired capsule endoscopy with two different devices: a randomized study

D.  Hartmann1 , A.  Eickhoff1 , U.  Damian1 , J.  F.  Riemann1
  • 1Department of Gastroenterology, Academic Teaching Hospital, Ludwigshafen am Rhein, Germany
Weitere Informationen

Publikationsverlauf

submitted 11 July 2007

accepted after revision 8 August 2007

Publikationsdatum:
10. Dezember 2007 (online)

Background and study aims: Capsule endoscopy is an established technique in the evaluation of obscure gastrointestinal bleeding. The primary aim of the study is to compare the diagnostic yield of the two different capsule endoscopes.

Patients and methods: Patients with signs of mid-gastrointestinal bleeding after negative upper endoscopy and colonoscopy studies were included. Patients were randomized to undergo two capsule endoscopies using different capsule endoscopes (Given Pillcam SB and Olympus EndoCapsule) in random order.

Results: Forty patients (18 women, 22 men) were included in the study. All EndoCapsules reached the colon within the mean recording time of 591 ± 52 minutes, whereas 33 out of 40 PillCam SB reached the colon within the mean recording time of 471 ± 27 minutes. Lesions were detected in 31 patients: with both devices in 24, only by PillCam SB in 2, and, conversely, only by EndoCapsule in 5 (not significant). With regard to lesions with high bleeding potential (P2 lesions), PillCam SB detected them in 22 patients, EndoCapsule in 25 patients (not significant). In all four cases of intestinal P2 lesions that were not detected by the PillCam SB but were detected by the EndoCapsule, the PillCam SB had not reached the cecum.

Conclusion: In this study there was a statistically nonsignificant trend for the EndoCapsule to detect more bleeding sources in patients with suspected small bowel bleeding than did the Pillcam SB, which may have been due to the longer recording times with the currently available EndoCapsule.

References

  • 1 Triester S L, Leighton J A, Leontiadis G I. et al . A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding.  Am J Gastroenterol. 2005;  100 2407-2418
  • 2 Marmo R, Rotondano G, Piscopo R. et al . Meta-analysis: capsule enteroscopy vs. conventional modalities in diagnosis of small bowel diseases.  Aliment Pharmacol Ther. 2005;  22 595-604
  • 3 Ell C, Remke S, May A. et al . The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding.  Endoscopy. 2002;  34 685-689
  • 4 Hartmann D, Schmidt H, Bolz G. et al . A prospective two-center study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding.  Gastrointest Endosc. 2005;  61 826-832
  • 5 Hartmann D, Schilling D, Bolz G. et al . Capsule endoscopy versus push enteroscopy in patients with occult gastrointestinal bleeding.  Z Gastroenterol. 2003;  41 377-382
  • 6 Rey J F, Gay G, Kruse A, Lambert R,. ESGE Guidelines Committee . European Society of Gastrointestinal Endoscopy guideline for video capsule endoscopy.  Endoscopy. 2004;  36 656-658
  • 7 Rey J F, Ladas S, Alhassani A, Kuznetsov K,. ESGE Guidelines Committee . European Society of Gastrointestinal Endoscopy (ESGE). Video capsule endoscopy: update to guidelines (May 2006).  Endoscopy. 2006;  38 1047-1053
  • 8 Delvaux M, Friedman S, Keuchel M. et al . Structured terminology for capsule endoscopy: results of retrospective testing and validation in 766 small-bowel investigations.  Endoscopy. 2005;  37 945-950
  • 9 Saurin J C, Delvaux M, Gaudin J L. et al . Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push-enteroscopy.  Endoscopy. 2003;  35 576-584
  • 10 Cave D, Fleischer C, Gostout C. et al . A multicenter randomized comparison of the EndoCapsule: Olympus Inc and the PillCam SB: GivenImaging in patients with obscure gastrointestinal bleeding.  Gastrointest Endosc. 2007;  65 AB125
  • 11 Rondonotti E, Spada C, Cave D. et al . Video capsule enteroscopy in the diagnosis of celiac disease: a multicenter study.  Am J Gastroenterol. 2007;  102 1624-1631
  • 12 Sturniolo G C, Di Leo V, Vettorato M G. et al . Small bowel exploration by wireless capsule endoscopy: results from 314 procedures.  Am J Med. 2006;  119 341-347
  • 13 Bar-Meir S, Eliakim R, Nadler M. et al . Second capsule endoscopy for patients with severe iron deficiency anemia.  Gastrointest Endosc. 2004;  60 711-713
  • 14 Jones B H, Fleischer D E, Sharma V K. et al . Yield of repeat wireless video capsule endoscopy in patients with obscure gastrointestinal bleeding.  Am J Gastroenterol. 2005;  100 1058-1064

D. Hartmann, MD

Department of Medicine C
Klinikum der Stadt Ludwigshafen GmbH

Bremserstrasse 79
67063 Ludwigshafen am Rhein
Germany

Fax: +49-621-5034114

eMail: medcluhartmann@t-online.de