Abstract
Background
Almost 70–80 % of patients with Crohn’s disease and virtually all patients with ulcerative colitis have colorectal mucosa involvement. Colon capsule endoscopy is an interesting option for patients unable or unwilling to undergo colonoscopy. We report our experience with the second-generation colon capsule PillCam® COLON 2 in the detection of significant lesions in patients with known or suspected Crohn’s disease, who refused colonoscopy or underwent incomplete colonoscopic exam.
Methods
We have retrospectively reviewed the results of capsule endoscopy in 6 patients who refused colonoscopy (n = 3) or underwent incomplete colonoscopic exam (n = 3) between March 2011 and October 2012. In all patients, a CT scan was obtained before capsule endoscopy to rule out significant stenosis.
Results
In our series of 6 patients, 4 had both small bowel and colonic involvement. The use of the PillCam® COLON 2 capsule allowed a thorough examination and evaluation of the mucosal lesions with high acceptability, the method being perceived as noninvasive by the patients. No adverse events related to the capsule or bowel preparation were recorded.
Conclusion
In this patient population, PillCam® COLON 2 capsule endoscopy was safe. The capsule findings had an important impact on treatment decisions and patient management.
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References
Abraham C, Cho JH (2009) Inflammatory bowel disease. N Engl J Med 361:2066–2078
Bourreille A, Ignjatovic A, Aabakken L et al (2009) Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: an international OMED-ECCO consensus. Endoscopy 41:618–637
De Melo SW Jr, Di Palma JA (2012) The role of capsule endoscopy in evaluating inflammatory bowel disease. Gastroenterol Clin North Am 41:315–323
Dionisio PM, Gurudu SR, Leighton JA et al (2010) Capsule endoscopy has a significantly higher diagnostic yield in patients with suspected and established small-bowel Crohn’s disease: a meta-analysis. Am J Gastroenterol 105:1240–1249
Mergener K, Ponchon T, Gralnek I et al (2007) Literature review and recommendations for clinical application of small-bowel capsule endoscopy, based on a panel discussion by international experts. Consensus statements for small-bowel capsule endoscopy, 2006/2007. Endoscopy 39:895–909
Spada C, Hassan C, Galmiche JP et al (2012) Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 44:527–536
Ye CA, Gao YJ, Ge ZZ et al (2013) PillCam COLON capsule endoscopy versus conventional colonoscopy for the detection of the severity and extent of ulcerative colitis. J Dig Dis 14:117–124
Sung J, Ho KY, Chiu HM, Ching J, Travis S, Peled R (2012) The use of Pillcam Colon in assessing mucosal inflammation in ulcerative colitis: a multicenter study. Endoscopy 44:754–758
Meister T, Heinzow HS, Domagk D et al (2013) Colon capsule endoscopy versus standard colonoscopy in assessing disease activity of ulcerative colitis: a prospective trial. Tech Coloproctol. doi:10.3748/wjg.v19.i6.874
Spada C, Hassan C, Munoz-Navas M et al (2011) Second-generation colon capsule endoscopy compared with colonoscopy. Gastrointest Endosc 74:581–589
Leighton JA, Rex DK (2011) A grading scale to evaluate colon cleansing for the PillCam COLON capsule: a reliability study. Endoscopy 43:123–127
Dafnis G, Granath F, Pahlman L et al (2005) Patient factors influencing the completion rate in colonoscopy. Dig Liver Dis 37:113–118
Ordas I, Rimola J, Rodriguez S, Gallego M, Ricart E, Panes J (2012) Imaging of the colon in inflammatory bowel disease: ready for prime time? Curr Drug Targets 13:1252–1260
Liao Z, Gao R, Xu C, Li ZJ (2010) Indications and detection, completion, and retention rates of small-bowel capsule endoscopy: a systematic review. Gastrointest Endosc 71:280–286
Höög CM, Bark LÅ, Arkani J, Gorsetman J, Broström O, Sjöqvist U (2012) Capsule retentions and incomplete capsule endoscopy examinations: an analysis of 2300 examinations. Gastroenterol Res Pract 2012:518718
Cheifetz AS, Kornbluth AA, Legnani P et al (2006) The risk of retention of the capsule endoscope in patients with known or suspected Crohn’s disease. Am J Gastroenterol 101:2218–2222
Karagiannis S, Faiss S, Mavrogiannis C (2009) Capsule retention: a feared complication of wireless capsule endoscopy. Scand J Gastroenterol 44:1158–1165
Rana SS, Bhasin DK, Nagi B et al (2012) Evaluation of barium meal follow-through and barium enteroclysis before capsule endoscopy in obscure gastrointestinal bleeding. Hepatogastroenterology 59:418–421
Herrerias JM, Leighton JA, Costamagna G et al (2008) Agile patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy. Gastrointest Endosc 67:902–909
Sciaudone G, Pellino G, Guadagni I, Pezzullo A, Selvaggi F (2010) Wireless capsule endoscopy years after Michelassi stricturoplasty for Crohn’s disease. Acta Chir Belg 110:213
Postgate AJ, Burling D, Gupta A, Fitzpatrick A, Fraser C (2008) Safety, reliability and limitations of the given patency capsule in patients at risk of capsule retention: a 3-year technical review. Dig Dis Sci 53:2732–2738
Doherty GA, Moss AC, Cheifetz AS (2011) Capsule endoscopy for small-bowel evaluation in Crohn’s disease. Gastrointest Endosc 74:167–175
Long MD, Barnes E, Isaacs K, Morgan D, Herfarth HH (2011) Impact of capsule endoscopy on management of inflammatory bowel disease: a single tertiary care center experience. Inflamm Bowel Dis 17:1855–1862
Dignass A, Van Assche G, Lindsay JO et al European Crohn’s and Colitis Organisation (ECCO) (2010) The second European evidence-based Consensus on the diagnosis and management of Crohn’s disease: Current management. J Crohns Colitis 4:28–62
Acknowledgments
This research was funded by the European Society of Gastrointestinal Endoscopy-Given Imaging research grant awarded to Dr Lucian Negreanu in 2010.
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Negreanu, L., Smarandache, G. & Mateescu, R.B. Role of capsule endoscopy Pillcam COLON 2 in patients with known or suspected Crohn’s disease who refused colonoscopy or underwent incomplete colonoscopic exam: a case series. Tech Coloproctol 18, 277–283 (2014). https://doi.org/10.1007/s10151-013-1054-3
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DOI: https://doi.org/10.1007/s10151-013-1054-3