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Contraindications for video capsule endoscopy

World Journal of Gastroenterology 2016年第45期22卷 9898-9908页

作者： dirk bandorski Niehls Kurniawan Peter Baltes Reinhard Hoeltgen Matthias Hecker Dominik Stunder Martin Keuchel University of Giessen and Marburg Lung Center Member of the German Center for Lung Research (DZL) Clinic for Internal Medicine Bethesda Krankenhaus Bergedorf Klinikum Westmünsterland St. Agnes-Hospital Bocholt Rhede Medical Clinic 1 Cardiology/Electrophysiology Research Center for Bioelectromagnetic Interaction (femu) Institute of Occupational and Social Medicine RWTH Aachen University Hospital

Video capsule endoscopy(VCE) has been applied in the last 15 years in an increasing field of applications. Although many contraindications have been put into perspective, some precautions still have to be considered. Known stenosis of the gastrointestinal tract is a clear contraindication for VCE unless surgery is already scheduled or at least has been considered as an optional treatment modality. In patients with a higher incidence of stenosis, as in an established diagnosis of Crohn's disease, clinical signs of obstruction, prior radiation or surgical small bowel resection, a preceding test with the self-dissolving patency capsule can override this contraindication. Endoscopic placement of the capsule should be considered in patients with swallowing disorders to avoid aspiration. Esophageal or gastric motility disorders may require endoscopic capsule transport or application of prokinetics if the real-time viewer proofs delayed transit. In pregnant women, VCE should be restricted to urgent cases where diagnosis cannot be postponed after delivery, as data on safety are missing. There is theoretical and clinical evidence that patients with implanted cardiac devices such as a pacemaker, cardioverters or left heart assist devices, can safely undergo VCE in spite of still existing contraindication by manufacturers. Children from the age of 2 years have safely undergone VCE. Although video capsules are not proven safe with magnetic resonance imaging(MRI), first single cases of patients incidentally undergoing MRI with an incorporated capsule have been reported, showing susceptibility artifacts but no signs of clinical harm.

关键词： Video capsule endoscopy Contraindications Stenosis Pacemaker Aspiration Pregnancy Magnetic resonance imaging

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Interference between pacemakers/implantable cardioverter defibrillators and video capsule endoscopy

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World Journal of Gastrointestinal Endoscopy 2013年第4期5卷 201-202页

作者： dirk bandorski Johannes Gehron Reinhard Hltgen Medical Clinic Ⅱ University Hospital Giessen und Marburg GmbH Department of Cardiac Surgery University Hospital Giessen und Marburg GmbH Medical Clinic Ⅲ St.-Agnes Hospital Bocholt

Our Letter to the Editor, related to the article "Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry" by Cuschieri et al , comments on some small errors, that slipped into the authors discussions. The given informations concerning the pacemakerand implantable cardioverter defibrillators modes were inaccurate and differ between the text and the table. Moreover, as 8 of 20 patient's pacemakers were programmed to VOO or DOO ("interference mode") and one patient was not monitored by telemetry during capsule endoscopy, 9 of 20 patients (45%) lack the informations of possible interference between capsule endoscopy their implanted device. Another objection refers to the interpretation of an electrocardiogram (figure 1, trace B) presented: in contrast to the author's opinion the marked spike should be interpreted as an artefact and not as "undersensing of a fibrillatory wave". Finally, three comments to cited reviews were not complete respectively not quoted correctly.

关键词： Capsule endoscopy Small bowel capsule endoscopy Interference Cardiac pacemaker Implantable cardioverter defibrillator Telemetry

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