A re-review of caspule endoscopies of patients referred for deep enteroscopy changes their management

International Journal of Gastrointestinal Intervention 2014년 3권 2호 p.89 ~ p.92

(Gray Meagan) - Gachon University Gil Medical Center Department of Internal Medicine
(Moore J. Matthew) - University of South Carolina Division of Gastroenterology and Hepatology
(Brock Andrew) - University of South Carolina Division of Gastroenterology and Hepatology

Abstract

Background: Patients are commonly referred to tertiary centers for deep enteroscopy because of abnormal findings on video capsule endoscopy (VCE). The aim of this study was to determine how often clinical management changes when VCEs are reviewed by an enteroscopist prior to scheduling a procedure.

Methods: A retrospective review was performed of patients referred for deep enteroscopy because of abnormal capsule endoscopy. All VCE images were reviewed prospectively by the tertiary center’s enteroscopist. Patients were then scheduled for deep enteroscopy or other management based on the capsule review. The rate of disagreement in the capsule findings, changes in management, and the diagnostic and therapeutic yield of enteroscopy were calculated.

Results: Video capsule endoscopy was available in 45 patients who were referred for deep enteroscopy. The mean age was 61 years (51% were females). Indications included obscure GI bleeding (37 patients), abnormal imaging (3 patients), abdominal pain (2 patients), Peutz-Jegher syndrome (2 patients), and weight loss (1 patient). Referring physician findings included polyps or masses (13 patients), angioectasia (13 patients), ulcers (9 patients), active bleeding (9 patients), nonspecific findings (8 patients), and normal (2 patients). A capsule review led to disagreement of the findings of 13 (29%) patients and led to a change in the management of 9 (20%) patients. The most common reason for a change in management was overcalled lesions. Thirty-seven patients underwent enteroscopy with a diagnostic yield of 48.8% and therapeutic intervention in 24.4%.

Conclusion: A review of referral VCE studies led to a change in management in a large percentage of patients, particularly when the indication was polyp, mass, or ulcer. Patients referred for deep enteroscopy should have their capsule re-read by an enteroscopist prior to scheduling the procedure.

키워드

deep enteroscopy, review, video capsule endoscopy
원문 및 링크아웃 정보
등재저널 정보
학술진흥재단(KCI) 
주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
Video capsule endoscopy Indications included obscure GI bleeding (37 patients), abnormal imaging (3 patients), abdominal pain (2 patients), Peutz-Jegher syndrome (2 patients), and weight loss (1 patient).
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
KCD코드
ICD 03
건강보험코드