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Contraindications for video capsule endoscopy

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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

Meckel's diverticulum diagnosis by video capsule endoscopy: A case report and review of literature

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World Journal of Clinical Cases 2018年第14期6卷 791-799页

作者： Diego García-Compeán Alan R Jiménez-Rodríguez Angel N Del Cueto-Aguilera Gilberto Herrera-Quinones José A González-González Héctor J Maldonado-Garza Gastroenterology Service and Department of Internal Medicine Faculty of Medicine University Hospital "Dr. José E. González" Universidad Autónoma de Nuevo León Monterrey 64700 Nuevo León México

BACKGROUND Meckel’s diverticulum （MD） occurs predominantly in chil-dren and adolescents. It is rarely diagnosed in adults. Preoperative diagnosis is diffcult due to low sensitivity of the radiological imaging studies. The role of video capsule endoscopy （VCE） in the diagnosis of MD is unknown, and the endoscopic patterns are not defned. We will describe four of our cases of MD evaluated with VCE and make a review of the literature focusing on the endoscopic *** SUMMARYWe present four cases of MD confirmed by surgery. They were all adult males with ages going from 18 to 50 years, referred to our service from 2004 to 2018, due to obscure gastrointestinal bleeding （OGIB）. TheyGarcía-Compeán D et al . Merckel’s diverticulum diagnosis by VCEhad a history of 1 mo to 10 years of overt and occult bleeding episodes. Laboratory blood test showed an iron-deficiency anemia from 4 to 9 g/dL of hemoglo-bin that required multiple hospitalizations and blood transfusions in all cases. Repeated upper digestive endoscopies and colonoscopies were negative. Small bowel was examined with VCE, which revealed double lumen images in all cases, one with polyps and three with circumferential ulcers in the diverticulum. However, based on VCE findings, preoperative diagnosis of MD was suggested only in two patients. capsule was retain-ed in one patient, which was recovered with surgery. The anatomopathological report revealed ulcerated ectopic gastric mucosa in all *** is useful for the diagnosis of MD. However, endo-scopic characteristics must be recognized in order to establish preoperative diagnosis.

关键词： Meckel’s diverticulum Endoscopic features video capsule endoscopy Wireless capsule endoscopy Review Case report

video capsule endoscopy in inflammatory bowel disease

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World Journal of Gastrointestinal endoscopy 2016年第14期8卷 477-488页

作者： Paul D Collins Department of Gastroenterology and Hepatology Royal Liverpool University Hospital

video capsule endoscopy (VCE) has evolved to become an important tool for the non-invasive examination of the small bowel, which hitherto had been relatively inaccessible to direct visualisation. VCE has been shown to play a role in monitoring the activity of small bowel Crohn’s disease and can be used to assess the response to anti-inflammatory treatment in Crohn’s disease. For those patients with Crohn’s disease who have undergone an intestinal resection, VCE has been assessed as a tool to detect post-operative recurrence. VCE may also aid in the reclassification of patients with a diagnosis of Inflammatory Bowel Disease Unclassified to Crohn’s disease. The evolution of colon capsule endoscopy (CCE) has expanded the application of this technology further. The use of CCE to assess the activity of ulcerative colitis has been described. This advance in capsule technology has also fuelled interest in its potential role as a minimally invasive tool to assess the whole of GI tract opening the possibility of its use for the panenteric assessment of Crohn’s disease. VCE is a safe procedure. However, the risk of a retained capsule is higher in patients with suspected or confirmed Crohn’s disease compared with patients having VCE examination for other indications. A retained video capsule is rare after successful passage of a patency capsule which may be utilised to pre-screen patients undergoing VCE. This paper describes the use of VCE in the assessment of inflammatory bowel disease.

关键词： video capsule endoscopy Inflammatory bowel diseases Crohn&rsquo s disease Ulcerative colitis Patency capsule

Artificial intelligence as a means to improve recognition of gastrointestinal angiodysplasia in video capsule endoscopy

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Artificial Intelligence in Gastrointestinal endoscopy 2021年第4期2卷 179-184页

作者： Gerald A Cox II Christian S Jackson Kenneth J Vega Department of Medicine Loma Linda University Medical CenterLoma LindaCA 92354United States Gastroenterology Section VA Loma Linda Healthcare SystemLoma LindaCA 92357United States Division of Gastroenterology and Hepatology Augusta University-Medical College of GeorgiaAugustaGA 30912United States

Gastrointestinal angiodysplasia(GIAD)is defined as the pathological process where blood vessels,typically venules and capillaries,become engorged,tortuous and thin walled–which then form arteriovenous connections within the mucosal and submucosal layers of the gastrointestinal *** are a significant cause of gastrointestinal bleeding and are the main cause for suspected small bowel *** make the diagnosis,gastroenterologists rely on the use of video capsule endoscopy(VCE)to“target”***,the use of VCE can be cumbersome secondary to reader fatigue,suboptimal preparation,and difficulty in distinguishing *** human eye is *** same capsule study read by two different readers are noted to have miss rates like other forms of *** intelligence(AI)has been a means to bridge the gap between human imperfection and recognition of *** use of AI in VCE have shown that detection has improved,however the other burdens and limitations still need to be *** use of AI for the diagnosis of GIAD shows promise and the changes needed to enhance the current practice of VCE are near.

关键词： Artificial intelligence video capsule endoscopy Gastrointestinal angiodysplasia Detection Bleeding Small bowel

Effect of small bowel transit time on accuracy of video capsule endoscopy in evaluating suspected small bowel bleeding

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2022年第6期13卷 88-95页

作者： Nandakumar Mohan Simone Jarrett Alexander Pop Daniel Rodriguez Robert Dudnick Internal Medicine Einstein Medical Center PhiladelphiaPhiladelphiaPA 19141United States Division of Gastrointestinal Diseases and Hepatology Einstein Medical Center PhiladelphiaPhiladelphiaPA 19141United States Department of Urban Health and Nutrition Lasalle UniversityPhiladelphiaPA 19141United States

BACKGROUND Obscure small bowel bleeding is defined as gastrointestinal bleeding(GIB)that is unidentifiable with esophagogastroduodenoscopy and a colonoscopy with video capsule endoscopy(VCE)being the next gold standard step for *** bowel transit time(SBTT)is a metric of a VCE study that is defined as the time the capsule takes to travel through the small *** To determine if SBTT within the VCE study,correlates to overall detection of obscure small bowel ***,we attempted to identify any existing correlation between SBTT and re-bleeding after a negative VCE *** This is a single center retrospective analysis of VCE studies performed for overt and occult GIB at Einstein Medical Center,Philadelphia,between 2015 and *** criteria primarily consisted of patients 18 years or older who had a VCE study done as part of the workup for a *** with incomplete VCEs,poor preparation,or with less than 6 mo of follow up were excluded.A re-bleeding event was defined either as overt or occult within a 6-mo *** rebleeding was defined as Visible melena or hematochezia with>2 gm/dL drop in hemoglobin defined an overt re-bleeding event;whereas an unexplained>2 gm/dL drop in hemoglobin with no visible bleeding defined an occult *** Results indicated that there was a significant and positive point biserial correlation between SBTT of 220 min and detection of a bleeding focus with a statistically significant p value of ***,the area under the curve was negligible when trying to identify a threshold time for SBTT to discriminate between risk of re-bleeding events after a negative *** In terms of SBTT and association with accuracy of VCE finding a bleeding focus,220 min was found to be adequate transit time to accurately find a bleeding focus,when *** was found that no threshold SBTT could be identified to help predict re-bleeding after a negative VCE.

关键词： Small bowel transit time endoscopy video capsule endoscopy Obscure bleed Small bowel Anemia

Muscovite is protective against non-steroidal anti-inflammatory drug-induced small bowel injury

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World Journal of Gastroenterology 2014年第31期20卷 11012-11018页

作者： Chen Huang Bin Lu Yi-Hong Fan Lu Zhang Ning Jiang Shuo Zhang Li-Na Meng Department of Gastroenterology The First Affiliated Hospital of Zhejiang Chinese Medical University

AIM: To evaluate the effect of muscovite in preventing small bowel injury induced by nonsteroidal anti-inflammatory drugs (NSAIDs).

关键词： Muscovite Nonsteroidal anti-inflammatory drugs Small intestinal injury video capsule endoscopy

Update on imaging of Peutz-Jeghers syndrome

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World Journal of Gastroenterology 2014年第31期20卷 10864-10875页

作者： Catherine Tomas Philippe Soyer Anthony Dohan Xavier Dray Mourad Boudiaf Christine Hoeffel Department of Radiology H?pital Robert Debré51092 Reims Cedex France Department of Abdominal Imaging H?pital Lariboisière-AP-HP and Université Diderot Paris 775475 Paris Cedex 10 France Department of Digestive Diseases H?pital Lariboisière-AP-HP and Université Diderot-Paris 775475 Paris Cedex 10 France

Peutz-Jeghers syndrome(PJS) is a rare, autosomal dominant disease linked to a mutation of the STK 11 gene and is characterized by the development of benign hamartomatous polyps in the gastrointestinal tract in association with a hyperpigmentation on the lips and oral mucosa. Patients affected by PJS have an increased risk of developing gastrointestinal and extra-digestive cancer. Malignancy most commonly occurs in the smallbowel. Extra-intestinal malignancies are mostly breast cancer and gynecological tumors or, to a lesser extent, pancreatic cancer. These polyps are also at risk of acute gastrointestinal bleeding, intussusception and bowel obstruction. Recent guidelines recommend regular smallbowel surveillance to reduce these risks associated with PJS. Small-bowel surveillance allows for the detection of large polyps and the further referral of selected PJS patients for endoscopic enteroscopy or surgery. video capsule endoscopy, double balloon pushed enteroscopy,multidetector computed tomography and magnetic resonance enteroclysis or enterography, all of which are relatively new techniques, have an important role in the management of patients suffering from PJS. This review illustrates the pathological, clinical and imaging features of small-bowel abnormalities as well as the role and performance of the most recent imaging modalities for the detection and follow-up of PJS patients.

关键词： Peutz-Jeghers syndrome Small-bowel disease Small bowel polyps Intussusception Double balloon enteroscopy video capsule endoscopy Abdomen,Magnetic resonance Abdomen Computed tomography

Treatment of gastrointestinal bleeding in left ventricular assist devices:A comprehensive review

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World Journal of Gastroenterology 2020年第20期26卷 2550-2558页

作者： Srikanth Vedachalam Gokulakrishnan Balasubramanian Garrie J Haas Somashekar G Krishna Department of Internal Medicine The Ohio State University Wexner Medical CenterColumbusOH 43210United States Division of Gastroenterology Hepatology and NutritionThe Ohio State University Wexner Medical CenterColumbusOH 43210United States Division of Cardiovascular Medicine The Ohio State University Wexner Medical CenterColumbusOH 43210United States

Left ventricular assist devices(LVAD)are increasingly become common as life prolonging therapy in patients with advanced heart *** devices are now used as definitive treatment in some patients given the improved durability of continuous flow ***,continuous flow LVADs are fraught with complications such as gastrointestinal(GI)bleeding that are primarily attributed to the formation of arteriovenous *** frequent GI bleeding,antiplatelet and anticoagulation therapies are usually discontinued increasing the risk of life-threatening *** bowel bleeds account for 15%as the source and patients often undergo multiple endoscopic *** strategies include resuscitative measures and endoscopic *** treatment is with *** treatment options include thalidomide,angiotensin converting enzyme inhibitors/angiotensinⅡreceptor blockers,estrogen-based hormonal therapies,doxycycline,desmopressin and *** research has explored the mechanism of frequent GI bleeds in this population,including destruction of von Willebrand factor,upregulation of tissue factor,vascular endothelial growth factor,tumor necrosis factor-α,tumor growth factor-β,and angiopoetin-2,and downregulation of *** addition,healthcare resource utilization is only increasing in this patient population with higher admissions,readmissions,blood product utilization,and *** some of the novel endoscopic and medical therapies for LVAD bleeds are still in their development stages,these tools will yet be crucial as the number of LVAD placements will likely only increase in the coming years.

关键词： Left ventricular assist device Push enteroscopy Double balloon enteroscopy video capsule endoscopy Octreotide Bevacizumab Gastrointestinal bleeding

Comment on “Artificial intelligence in gastroenterology: A state-ofthe- art review”

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World Journal of Gastroenterology 2022年第16期28卷 1722-1724页

作者： Thomas Bjørsum-Meyer Anastasios Koulaouzidis Gunnar Baatrup Department of Surgery Odense University HospitalSvendborg 5700Denmark Department of Clinical Research University of Southern DenmarkFaculty of Health ScienceOdense 5230Denmark

Colon capsule endoscopy(CCE)was introduced nearly two decades ***,it was limited by poor image quality and short battery time,but due to technical improvements,it has become an equal diagnostic alternative to optical colonoscopy(OC).Hastened by the coronavirus disease 2019 pandemic,CCE has been introduced in clinical practice to relieve overburdened endoscopy units and move investigations to out-patient clinics.A wider adoption of CCE would be bolstered by positive patient experience,as it offers a diagnostic investigation that is not inferior to other *** shortcomings of CCE include its inability to differentiate adenomatous polyps from hyperplastic *** this issue would improve the stratification of patients for polyp *** intelligence(AI)has shown promising results in polyp detection and characterization to minimize incomplete CCEs and avoid needless *** AI appears to be a needed application to enable near-real-time decision-making in order to diminish patient waiting times and avoid superfluous subsequent *** this letter,we discuss the potential and role of AI in CCE as a diagnostic tool for the large bowel.

关键词： video capsule endoscopy Wireless capsule endoscopy Artificial intelligence Colonic polyps Endoscopic surgical procedures Colon neoplasm