Capsule Endoscopy: Indications, Findings and Complications among Patients with Suspected Small Bowel Lesions

Abstract

Background/Aims: Until a few years back, evaluation of small bowel pathology was unsatisfactory
because of the inability to completely visualize the small bowel mucosa with the available
endoscopic and radiological techniques. Since the advent of capsule endoscopy at the beginning
of the millennium it became the gold standard for the diagnosis of most diseases of the
small intestine. At present capsule endoscopy still have some limitations; it lacks the ability to
obtain tissue biopsy or provide endoscopic treatment and cannot be controlled remotely. But
the near future foreshadows capsules that can perform drug delivery and tissue sampling. Although,
capsule endoscopy is considered a simple, safe, and a non-invasive reliable technique,
retention of the capsule is the main complication of the procedure.
Patients and Methods: This study was conducted to assess the indications, findings, and complications
of CE among patients with suspected small bowel lesions. It also studies the effect
of small bowel transit time on the diagnostic yield of the capsular endoscopy and the effect of
gastric transit time on complete small bowel examination.
A total of 119 patients with suspected small bowel disease received CE examination at the department
of gastroenterology of Ibn-sina and Fedail Hospitals in Sudan, during the period from
January 2010 to June 2011.
Conclusion: Capsule endoscopy is a very useful diagnostic tool, especially in the presence of
a strong suspicion of small bowel pathology. The duration of small bowel transit time during
capsule endoscopy does not affect its diagnostic yield. The latter is affected by the underlying
indication. Capsule retention was the main complication and in 10% the capsule examination
was not complete as the capsule did not reach the ileocecal valve. The gastric transit time was
not associated with complete examination rate. Repeating the capsule endoscopy in patients
with a previously negative capsule examination and a high suspicion of small bowel pathology
may reveal additional finding in the majority of patients.