Capsule enteroscopy

What are the advantages, disadvantages, and contraindications of capsule enteroscopy?

Advantages

• Approximately 60% yield of diagnosis for GIBOO

• Much better diagnostic yield than push enteroscopy and radiography

Disadvantages

  • • Capsule retention seen in 1% (usually at site of pathologic obstruction)
    • • Tumors
    • • Strictures
    • • Ulcers
    • • Crohn’s disease is the most common cause for capsule retention

Contraindications

• Esophageal stricture

• Zenker diverticulum

• Known intermittent or partial small bowel obstruction

• Not approved for use during pregnancy

In a patient with high likelihood of small bowel stricture or partial obstruction, a patency capsule (Given Imaging) should be performed before capsule endoscopy. The patency capsule is identical in size and shape to the PillCam capsule, but contains barium within a lactose shell that will dissolve within 2 days of ingestion. A plain radiograph is obtained at 24 to 30 hours after patency capsule ingestion. Small bowel luminal patency is suggested by passage of the capsule into the colon or toilet. Capsule endoscopy is contraindicated if the patency capsule is retained in the small bowel at 24 to 30 hours after ingestion.

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