Procedure

Wireless Capsule Endoscopy

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Wireless Capsule Endoscopy, Capsule Endoscopy

  • Indications
  1. Obscure Gastrointestinal Bleeding
    1. Presumed Small Intestinal Bleeding
    2. Blood loss Anemia and normal standard endoscopy
  2. Non-bleeding indications
    1. Suspected Crohn's Disease
    2. Suspected Small Bowel tumor
    3. Abnormal imaging study of the Small Bowel
    4. Refractory Celiac Sprue
    5. Familial Adenomatous Polyposis Syndrome
  • Contraindications
  1. Swallowing Disorders
  2. Pacemaker or other implantable electromedical device
  3. Small Bowel Obstruction, strictures or fistulas
  4. Pregnancy
  • Technique
  1. Preparation
    1. Fast for 10 hours and no purging or
    2. Two liter PEG given 6 hours before capsule or
    3. Single dose of Simethicone before procedure
  2. Patient swallows disposable wireless video capsule
    1. Capsule is 2.6 x 1.1 cm in size (PillCam ESO)
    2. Capsule has 6-8 hour battery life
    3. Capsule contains microchip camera and light source
  3. Patient wears recorder
    1. Camera transmits 2 images per second to recorder
  • Complications
  1. Stool impaction
  2. Small Bowel stricture
  3. Retention of pill camera
  • Efficacy
  1. Overall, capsule misses 36% of lesions
    1. Appleyard (2000) Gastroenterology [PubMed]
  2. Identifies bleeding source in 55-76%
    1. Contrast with push endoscopy sensitivity: 21-38%
  3. Accurate in Crohn's Disease diagnosis
    1. Test Sensitivity: 89%
    2. Test Specificity: 100%
    3. Dubcenco (2005) GI Endoscopy [PubMed]
  • References
  1. Costamagna (2002) Gastroenterology 123:999-1005 [PubMed]
  2. Ginsberg (2002) Gastrointest Endosc 56(5):621-4 [PubMed]