胶囊内镜对腹痛或腹泻患者的诊断作用

作     者：Fry L.C. Carey E.J. Shiff A.D. J.A.Leighton 孟欣颖 

作者机构：Division of Gastroenterology and HepatologyMayo Clinic13400 East Shea BoulevardScottsdaleAZ 85259United States.Dr 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第10期

页      面：25-26页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：胶囊内镜 诊断作用 腹泻患者 小肠疾病 克罗恩病 小肠镜 影像学检查 结肠镜 小肠造影 统计学资料 

摘      要：Background and Study Aims: Capsule endoscopy, proven effective for evaluation of obscure gastrointestinal bleeding and suspected Crohn’s disease, is increasingly used to investigate other small-intestine disorders, but its yield for other indications is not well known. We sought to evaluate its yield and findings for abdominal pain or diarrhea. Patients and Methods: Medical records of patients with abdominal pain or diarrhea ( 6 weeks’duration) who underwent capsule endoscopy between August 2001 and June 2004 were retrospectively reviewed for demographic data, indications, findings, diagnoses, complications, and radiologic studies. All patients had previous endoscopic or radiologic examinations (colonoscopy, enteroscopy, upper endoscopy, small-bowel series, computed tomography enterography, or computed tomography) demonstrating no abnormalities sufficient for diagnosis. Results: 64 patients (26 men; 38 women; mean age, 43 years; age range, 19-83 years) who met study criteria had 68 capsule endoscopy studies. Indications were abdominal pain (35 patients), diarrhea (14), or both (15). Complete small-bowel visualization with identification of the cecum was achieved in 81%; yield of positive findings was 9%(6 patients). By indications, the yield was 6%for abdominal pain, 14%for diarrhea, and 13%for both. Diagnoses included Crohn’s disease (3), enteropathy induced by nonsteroidal anti-inflammatory drugs (2), and submucosal tumor (1). Capsule retention occurred in two patients, requiring surgical removal. Conclusions: Capsule endoscopy had a low yield for evaluation of abdominal pain or diarrhea and cannot be recommended as a first-line test without further study. Nonetheless, it facilitated diagnosis in 9%of patients with negative endoscopic and radiologic examinations.