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At least 361 records · Page 20Linked to original sources
PubMed2006

The accuracy of PillCam ESO capsule endoscopy versus conventional upper endoscopy for the diagnosis of esophageal varices: a prospective three-center pilot study.

BACKGROUND AND STUDY AIMS: Variceal bleeding is a major complication of cirrhosis, and is associated with a 20 % mortality at 6 weeks. Current international guidelines recommend that patients with cirrhosis are screened by conventional upper endoscopy (esophagogastroduodenoscopy, EGD) in order to detect esophageal varices. The recently developed PillCam ESO esophageal capsule endoscope has been shown to be an accurate diagnostic tool in the investigation of patients with gastroesophageal reflux and Barrett's esophagus. We compared the PillCam ESO capsule endoscope with EGD for the detection of esophagogastric varices and portal hypertensive gastropathy in patients with cirrhosis. PATIENTS AND METHODS: A pilot trial was conducted at three sites. Patients with cirrhosis who were undergoing clinically indicated EGD for screening or surveillance for esophageal varices underwent a PillCam ESO study followed by an EGD within 48 hours. Capsule videos were assessed by an investigator who was blinded to the patient's medical history and EGD findings. RESULTS: A total of 23 of the 32 enrolled patients were found to have esophageal varices at both EGD and PillCam ESO endoscopy. In one patient PillCam ESO detected small varices that were not seen at EGD. The overall concordance between PillCam ESO and EGD was 96.9 % for the diagnosis of esophageal varices and 90.6 % for the diagnosis of portal hypertensive gastropathy. There were no adverse events related to PillCam ESO endoscopy. CONCLUSIONS: In a high-prevalence population, PillCam ESO may represent an accurate noninvasive alternative to EGD for the detection of esophageal varices and portal hypertensive gastropathy. A large-scale trial is underway to validate and expand these findings.

Endoscopes, Gastrointestinal↗
PubMed2006

Video capsule endoscopy and histology for small-bowel mucosa evaluation: a comparison performed by blinded observers.

BACKGROUND & AIMS: In view of the excellent quality of the images obtained and its magnification capability, videocapsule endoscopy was proposed as a promising tool to evaluate the degree of duodenal villous atrophy. We studied whether the capsule can discriminate different degrees of mucosal damage caused by different conditions; we also evaluated interobserver and intraobserver variability in the assessment of villous atrophy with the capsule. METHODS: Thirty-two patients underwent both gastroscopy with multiple duodenal biopsies and videocapsule endoscopy. Twenty-six had different forms of celiac disease with different stages of villous atrophy; 5 patients had irritable bowel syndrome and 1 had Crohn's disease. Videocapsule findings were evaluated blindly by 3 observers. Histologic Marsh criteria and a specifically developed classification of videocapsule mucosal patterns were used to compare videocapsule findings and histology. RESULTS: The study of the correlation between videocapsule and histologic findings showed a Kappa statistic of .45, .49, and .51 for observers 1, 2, and 3, respectively. The sensitivity was 90.5% for observer 1 and 95.2% for observers 2 and 3; the specificity was 63.6% for all observers. CONCLUSIONS: Videocapsule findings regarding the degree of intestinal mucosal atrophy show only moderate agreement with the histologic pattern; they have a very high sensitivity but a disappointing specificity. This method therefore cannot be proposed as an alternative to traditional biopsy examinations, but it suggests that a duodenal biopsy examination should be performed when an atrophic mucosal pattern is observed in patients undergoing videocapsule examination for other reasons.

Adolescent↗
PubMedDate not supplied

M2A capsule endoscopy. A breakthrough diagnostic tool for small intestine imaging.

It is estimated that 19 million people in the United States may suffer from diseases related to the small intestine, including obscure bleeding, irritable bowel syndrome, Crohns disease, chronic diarrhea, and cancer. Current diagnostic methods, including push enteroscopy and radiology, produce historically low diagnostic yield. Early studies show that the M2A Capsule Endoscope effectively visualizes the entire small bowel and demonstrates a 71% superior diagnostic yield when compared to push enteroscopy according to clinical trials reviewed by the FDA. In addition to potentially higher diagnostic yields, it provides a noninvasive diagnostic alternative where none previously existed. The M2A Capsule Endoscope received FDA clearance in August 2001 and is currently in use at major medical centers throughout the United States and Europe.

Endoscopes, Gastrointestinal↗
PubMedDate not supplied

Video wireless capsule endoscopy: a diagnostic tool for early Crohn's disease.

Crohn's disease is a chronic immune-mediated disease that affects any or all segments of the gastrointestinal tract, but is mainly found in the small intestines or colon. Crohn's disease in the early stages present with symptoms such as chronic diarrhea, abdominal pain, and weight loss that may mimic other conditions and cause a delay in diagnosis. Many patients experience emotional difficulties related to this debilitating disease. Current procedures used to visualize the small bowel for diagnosis of Crohn's disease include small-bowel follow through, enteroclysis, and computerized tomography, but do not provide definition of the mucosal surface. Clinical research shows us the diagnostic yield of these tests are not as high as once thought. A new diagnostic tool, the M2A Video Capsule, can be used to visualize the small bowel mucosa. With the detailed photo images provided by the capsule, the physician now has the ability to detect subtle changes in the mucosal lining that may be consistent with early Crohn's disease that were previously not available or identifiable. Earlier disease treatment and management may decrease the inflammatory changes that lead to bowel thickening and stricturing and have a positive impact on the patient's total quality of life.

Crohn Disease↗
PubMed2003

[Utility of capsule endoscopy in pediatric gastroenterology].

Wireless endoscopy is a new noninvasive diagnostic method that is able to visualize small bowel lesions. The instrument is small and carries a battery and microcamera that takes two photographs per second. It is indicated in cases of bleeding of unknown origin and for the diagnosis of inflammatory bowel disease, among other disorders. To date, it has mainly been used in adults. We believe that this instrument could play an important role in the pediatric age group since it is noninvasive and can be used to diagnose small bowel lesions, thus avoiding unnecessary diagnostic tests. We report the case of a girl with suspicion of Crohn's disease that was unconfirmed by conventional endoscopic techniques. The capsule showed small bowel lesions compatible with Crohn's disease. Corticosteroid treatment was initiated and the patient is now in clinical remission.

Adolescent↗