Digestive Diseases and Sciences

, Volume 54, Issue 1, pp 136–141 | Cite as

Capability of Capsule Endoscopy in Detecting Small Bowel Ulcers

  • Osman Ersoy
  • Ozgur Harmanci
  • Musa Aydinli
  • Bulent Sivri
  • Yusuf Bayraktar
Original Article
First Online:
Received:
Accepted:

Abstract

Capsule endoscopy (CE) has proved to be the preferred modality for mucosal pathologies of the small bowel. We evaluated the capability of CE for detecting small bowel ulcers and the contribution of CE in establishing the diagnosis. From a total of 66 patients who had undergone normal upper and lower endoscopy and small bowel follow-through, CE revealed previously undiagnosed ulcer(s) in the small intestines of 22 patients. Final diagnoses of the ulcers of these 22 patients were Crohn’s disease (n = 9), Behçet’s disease (n = 2), nonspecific jejunoileitis (n = 2), vasculitis (n = 1), gastrointestinal stromal tumor (n = 1), adenocarcinoma (n = 1), lymphoma (n = 1), multiple myeloma (n = 1), Meckel’s diverticulum (n = 1) and unknown (n = 3). Capsule endoscopy was extremely useful in establishing the diagnosis. In this study, proximal, distal and diffuse small bowel ulcers were determined at rates of 27.3, 59.0 and 13.7%, respectively. Capsule endoscopy facilitated the detection and assessment of ulcerated mucosal lesions located in the small bowel.

Keywords

Behçet’s disease Capsule endoscopy Crohn’s disease Non-steroidal anti-inflammatory drugs Small intestine ulcer 
This is a preview of subscription content, log in to check access.

References

  1. 1.
    Proctor DD, Panzini LA (2002) Isolated and diffuse ulcers of the small intestine. In: Feldman M, Friedman LS, Sleisenger MH (eds) Sleisenger and Fordran’s gastrointestinal and liver disease, 7th edn. Saunders, Philadelphia, pp 2081–2088Google Scholar
  2. 2.
    Eliakim AR (2006) Video capsule endoscopy of the small bowel (PillCam SB). Curr Opin Gastroenterol 22:124–127. doi: 10.1097/01.mog.0000203866.25384.be PubMedCrossRefGoogle Scholar
  3. 3.
    Ghosh S, Watts D, Kinnear M (2002) Management of gastrointestinal haemorrhage. Postgrad Med J 78:4–14. doi: 10.1136/pmj.78.915.4 PubMedCrossRefGoogle Scholar
  4. 4.
    Yamamoto H, Kita H, Sunada K et al (2004) Clinical outcomes of double-balloon endoscopy for the diagnosis and treatment of small-intestinal diseases. Clin Gastroenterol Hepatol 2:1010–1016. doi: 10.1016/S1542-3565(04)00453-7 Google Scholar
  5. 5.
    Tang SJ, Zanati S, Dubcenco E et al (2003) Capsule endoscopy regional transit abnormality: a sign of underlying small bowel pathology. Gastrointest Endosc 58:598–602PubMedGoogle Scholar
  6. 6.
    Ell C, Remke S, May A et al (2002) The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding. Endoscopy 34:685–689. doi: 10.1055/s-2002-33446 PubMedCrossRefGoogle Scholar
  7. 7.
    Mata A, Bordas JM, Feu F (2004) Wireless capsule endoscopy in patients with obscure gastrointestinal bleeding: a comparative study with push enteroscopy. Aliment Pharmacol Ther 20:189–194. doi: 10.1111/j.1365-2036.2004.02067.x PubMedCrossRefGoogle Scholar
  8. 8.
    Mylonaki M, Fritscher-Ravens A, Swain P (2003) Wireless capsule endoscopy: a comparison with push enteroscopy in patients with gastroscopy and colonoscopy negative gastrointestinal bleeding. Gut 52:1122–1126. doi: 10.1136/gut.52.8.1122 PubMedCrossRefGoogle Scholar
  9. 9.
    Lim RM, O’Loughlin CJ, Barkin JS (2002) Comparison of wireless capsule endoscopy (M2A) with push enteroscopy in the evaluation of obscure gastrointestinal bleeding. Am J Gastroenterol 97:S-31Google Scholar
  10. 10.
    Adler DG, Knipschield M, Gostout C (2004) A prospective comparison of capsule endoscopy and push enteroscopy in patients with GI bleeding of obscure origin. Gastrointest Endosc 59:492–498. doi: 10.1016/S0016-5107(03)02862-1 PubMedCrossRefGoogle Scholar
  11. 11.
    Saurin JC, Delvaux M, Gaudin JL et al (2003) Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: blinded comparison with video push enteroscopy. Endoscopy 35:576–584. doi: 10.1055/s-2003-38767 PubMedCrossRefGoogle Scholar
  12. 12.
    Hartmann D, Schilling D, Bolz G et al (2003) Capsule endoscopy versus push enteroscopy in patients with occult gastrointestinal bleeding. Z Gastroenterol 41:377–382. doi: 10.1055/s-2003-37313 PubMedCrossRefGoogle Scholar
  13. 13.
    Van Gossum A, Hittelet A, Schmit A et al (2003) A prospective comparative study of push and wireless-capsule enteroscopy in patients with obscure digestive bleeding. Acta Gastroenterol Belg 66:199–205. PubMedGoogle Scholar
  14. 14.
    Ge ZZ, Hu YB, Xiao SD (2004) Capsule endoscopy and push enteroscopy in the diagnosis of obscure gastrointestinal bleeding. Chin Med J (Engl) 117:1045–1049Google Scholar
  15. 15.
    Liangpunsakul S, Maglinte DD, Rex DK (2004) Comparison of wireless capsule endoscopy and conventional radiologic methods in the diagnosis of small bowel disease. Gastrointest Endosc Clin N Am 14:43–50. doi: 10.1016/j.giec.2003.10.004 PubMedCrossRefGoogle Scholar
  16. 16.
    Costamagna G, Shah SK, Riccioni ME et al (2002) A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease. Gastroenterology 123:999–1005. doi: 10.1053/gast.2002.35988 PubMedCrossRefGoogle Scholar
  17. 17.
    Liangpunsakul S, Chadalawada V, Rex D et al (2003) Wireless capsule endoscopy detects small bowel ulcers in patients with normal results from state of the art enteroclysis. Am J Gastroenterol 98:1295–1298. doi: 10.1111/j.1572-0241.2003.07471.x PubMedCrossRefGoogle Scholar
  18. 18.
    Hara AK, Leighton JA, Sharma VK et al (2005) Imaging of small bowel disease: comparison of capsule endoscopy, standard endoscopy, barium examination, and CT. Radiographics 25:697–718. doi: 10.1148/rg.253045134 PubMedCrossRefGoogle Scholar
  19. 19.
    Voderholzer WA, Beinhoelzl J, Rogalla P et al (2005) Small bowel involvement in Crohn’s disease: a prospective comparison of wireless capsule endoscopy and computed tomography enteroclysis. Gut 54:369–373. doi: 10.1136/gut.2004.040055 PubMedCrossRefGoogle Scholar
  20. 20.
    Remedios ML, Appleyard M (2005) Capsule endoscopy: current indications and future prospects. Intern Med J 35:234–239. doi: 10.1111/j.1445-5994.2005.00808.x PubMedCrossRefGoogle Scholar
  21. 21.
    Triester SL, Leighton JA, Leontiadis GI et al (2006) A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn’s disease. Am J Gastroenterol 101:954–964. doi: 10.1111/j.1572-0241.2006.00506.x PubMedCrossRefGoogle Scholar
  22. 22.
    American Society for Gastrointestinal Endoscopy (2002) Wireless capsule endoscopy. Gastrointest Endosc 56:621–624. doi: 10.1016/S0016-5107(02)70106-5 CrossRefGoogle Scholar
  23. 23.
    Delvaux M (2006) Capsule endoscopy in 2005: facts and perspectives. Best Pract Res Clin Gastroenterol 20:23–39. doi: 10.1016/j.bpg.2005.08.002 PubMedCrossRefGoogle Scholar
  24. 24.
    Ersoy O, Sivri B, Arslan S et al (2006) How much helpful is the capsule endoscopy for the diagnosis of small bowel lesions? World J Gastroenterol 28:3906–3910Google Scholar
  25. 25.
    Swain P (2005) Wireless capsule endoscopy and Crohn’s disease. Gut 54:323–326. doi: 10.1136/gut.2004.047282 PubMedCrossRefGoogle Scholar
  26. 26.
    Kasahara Y, Tanaka S, Nihino M et al (1981) Intestinal involvement in Behcet’s disease: review of 136 surgical cases in the Japanese literature. Dis Colon Rectum 24:103–106. doi: 10.1007/BF02604297 PubMedCrossRefGoogle Scholar
  27. 27.
    Smith JA, Siddiqui D (2002) Intestinal Behcet’s disease presenting as a massive acute lower gastrointestinal bleed. Dig Dis Sci 47:517–521. doi: 10.1023/A:1017999515606 PubMedCrossRefGoogle Scholar
  28. 28.
    Hara AK, Leighton JA, Sharma VK et al (2004) Small bowel: preliminary comparison of capsule endoscopy with barium study and CT. Radiology 230:260–265. doi: 10.1148/radiol.2301021535 PubMedCrossRefGoogle Scholar
  29. 29.
    Berner JS, Mauer K, Lewis BS (1994) Push and sonde enteroscopy for the diagnosis of obscure gastrointestinal bleeding. Am J Gastroenterol 89:2139–2142PubMedGoogle Scholar
  30. 30.
    Lewis B, Eisen G, Friedman S (2005) A pooled analysis to evaluate results of capsule endoscopy trials. Endoscopy 37:960–965. doi: 10.1055/s-2005-870353 PubMedCrossRefGoogle Scholar
  31. 31.
    Green PH, Jabri B (2003) Coeliac disease. Lancet 362:383–391.doi: 10.1016/S0140-6736(03)14027-5 PubMedCrossRefGoogle Scholar
  32. 32.
    Culliford A, Daly J, Diamond B et al (2005) The value of wireless capsule endoscopy in patients with complicated celiac disease. Gastrointest Endosc 62:55–61. doi: 10.1016/S0016-5107(05)01566-X PubMedCrossRefGoogle Scholar
  33. 33.
    Muller-Ladner U (2001) Vasculitides of the gastrointestinal tract. Best Pract Res Clin Gastroenterol 15:59–82. doi: 10.1053/bega.2000.0156 PubMedCrossRefGoogle Scholar
  34. 34.
    Venizelos I, Theodoridou S, Vakalopoulou S et al (2004) Acute large bowel pseudo-obstruction due to multiple myeloma. Leuk Lymphoma 45:1943–1945. doi: 10.1080/10428190410001697322 PubMedCrossRefGoogle Scholar
  35. 35.
    Yamamoto T, Maeda N, Kawasaki H (1995) Hepatic failure in a case of multiple myeloma-associated amyloidosis (k-AL). J Gastroenterol 30:393–397. doi: 10.1007/BF02347517 PubMedCrossRefGoogle Scholar
  36. 36.
    Cooper MM (1988) Metastatic calcification: an unusual cause of lower intestinal hemorrhage. N Y State J Med 88:389–390PubMedGoogle Scholar
  37. 37.
    Katz JA, Metz DC, Faigel DO (1994) Gastrointestinal bleeding from a gastric plasmacytoma. Am J Gastroenterol 89:642–643PubMedGoogle Scholar
  38. 38.
    Chang SS, Lu CL, Tsay SH et al (2001) Amyloidosis-induced gastrointestinal bleeding in a patient with multiple myeloma. J Clin Gastroenterol 32:161–163. doi: 10.1097/00004836-200102000-00015 PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Osman Ersoy
    • 1
  • Ozgur Harmanci
    • 2
  • Musa Aydinli
    • 2
  • Bulent Sivri
    • 2
  • Yusuf Bayraktar
    • 2
  1. 1.Department of GastroenterologyAtaturk Education and Research HospitalAnkaraTurkey
  2. 2.Department of GastroenterologyHacettepe University Faculty of MedicineAnkaraTurkey

Personalised recommendations