Double-headed small bowel capsule endoscopy: real-world experience at a tertiary referral centre

D.E. Yung, S. Douglas, J. Brzeszczynska, J.N. Plevris, A. Koulaouzidis

Research output: Contribution to journalMeeting Abstract

Abstract

Aims
Capsule endoscopy (CE) is a well-established mode of investigation for small bowel (SB) pathology. This study aims to characterise the potential benefits of using double-headed capsules (vs conventional single-headed ones) in a real-world cohort of patients referred for CE. We present initial results from a single centre as part of a multicentre British study.

Methods
Over a 9-month study period, patients referred for routine SBCE at a tertiary referral centre underwent double-headed CE in lieu of conventional single-headed CE. Clinical data were anonymised. One head (left or right) was chosen at random and reported by an expert reviewer. After an interval of 4 weeks, the other heads, also anonymised and in random order, were read and reported by the same reviewer. For each CE examination, the numbers and types of findings, and overall conclusion/diagnosis were compared between L/R heads.

Results
In total 98 CE examinations were performed. There were 3 stomach retentions, therefore 95 cases were analysed. Indications were:
1. SB bleeding (n = 53);
2. suspected SB inflammation or reassessment of known inflammatory bowel disease (IBD) (n = 28);
3. suspected SB malignancy (n = 8) and
4. others (n = 6).

The findings for each group are as follows:
1. 14/53 (26.4%) patients had differences in findings between L/R heads. The differences changed diagnosis in 6 (11.3%) patients.
2. 12/28 (42.9%) patients had differences between L/R heads, which changed diagnosis in 4 (14.3%) patients.
3. 1/8 (12.5%) patient had differences between L/R heads which changed the diagnosis in this patient.

Overall, use of two CE heads impacted the diagnosis in 11/95 (11.6%) of cases in our cohort.

Conclusions
Conventional single-headed CE has a relatively high proportion of negative examinations, often leading to multiple and repeated investigations in patients referred for suspected SB pathology.

Use of double-headed CE provides more information which has potential to change clinical diagnosis and therefore management.

Original languageEnglish
Article numberS9
JournalEndoscopy
Volume51
Issue number04
DOIs
Publication statusE-pub ahead of print - 18 Mar 2019
Externally publishedYes

Fingerprint

Capsule Endoscopy
Tertiary Care Centers
Head
Pathology
Inflammatory Bowel Diseases
Endoscopy
Multicenter Studies
Capsules
Stomach
Hemorrhage
Inflammation

Cite this

Yung, D.E. ; Douglas, S. ; Brzeszczynska, J. ; Plevris, J.N. ; Koulaouzidis, A. / Double-headed small bowel capsule endoscopy : real-world experience at a tertiary referral centre. In: Endoscopy. 2019 ; Vol. 51, No. 04.
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title = "Double-headed small bowel capsule endoscopy: real-world experience at a tertiary referral centre",
abstract = "AimsCapsule endoscopy (CE) is a well-established mode of investigation for small bowel (SB) pathology. This study aims to characterise the potential benefits of using double-headed capsules (vs conventional single-headed ones) in a real-world cohort of patients referred for CE. We present initial results from a single centre as part of a multicentre British study.MethodsOver a 9-month study period, patients referred for routine SBCE at a tertiary referral centre underwent double-headed CE in lieu of conventional single-headed CE. Clinical data were anonymised. One head (left or right) was chosen at random and reported by an expert reviewer. After an interval of 4 weeks, the other heads, also anonymised and in random order, were read and reported by the same reviewer. For each CE examination, the numbers and types of findings, and overall conclusion/diagnosis were compared between L/R heads.ResultsIn total 98 CE examinations were performed. There were 3 stomach retentions, therefore 95 cases were analysed. Indications were:1. SB bleeding (n = 53);2. suspected SB inflammation or reassessment of known inflammatory bowel disease (IBD) (n = 28);3. suspected SB malignancy (n = 8) and4. others (n = 6).The findings for each group are as follows:1. 14/53 (26.4{\%}) patients had differences in findings between L/R heads. The differences changed diagnosis in 6 (11.3{\%}) patients.2. 12/28 (42.9{\%}) patients had differences between L/R heads, which changed diagnosis in 4 (14.3{\%}) patients.3. 1/8 (12.5{\%}) patient had differences between L/R heads which changed the diagnosis in this patient.Overall, use of two CE heads impacted the diagnosis in 11/95 (11.6{\%}) of cases in our cohort.ConclusionsConventional single-headed CE has a relatively high proportion of negative examinations, often leading to multiple and repeated investigations in patients referred for suspected SB pathology.Use of double-headed CE provides more information which has potential to change clinical diagnosis and therefore management.",
author = "D.E. Yung and S. Douglas and J. Brzeszczynska and J.N. Plevris and A. Koulaouzidis",
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Double-headed small bowel capsule endoscopy : real-world experience at a tertiary referral centre. / Yung, D.E.; Douglas, S.; Brzeszczynska, J.; Plevris, J.N.; Koulaouzidis, A.

In: Endoscopy, Vol. 51, No. 04, S9, 18.03.2019.

Research output: Contribution to journalMeeting Abstract

TY - JOUR

T1 - Double-headed small bowel capsule endoscopy

T2 - real-world experience at a tertiary referral centre

AU - Yung, D.E.

AU - Douglas, S.

AU - Brzeszczynska, J.

AU - Plevris, J.N.

AU - Koulaouzidis, A.

PY - 2019/3/18

Y1 - 2019/3/18

N2 - AimsCapsule endoscopy (CE) is a well-established mode of investigation for small bowel (SB) pathology. This study aims to characterise the potential benefits of using double-headed capsules (vs conventional single-headed ones) in a real-world cohort of patients referred for CE. We present initial results from a single centre as part of a multicentre British study.MethodsOver a 9-month study period, patients referred for routine SBCE at a tertiary referral centre underwent double-headed CE in lieu of conventional single-headed CE. Clinical data were anonymised. One head (left or right) was chosen at random and reported by an expert reviewer. After an interval of 4 weeks, the other heads, also anonymised and in random order, were read and reported by the same reviewer. For each CE examination, the numbers and types of findings, and overall conclusion/diagnosis were compared between L/R heads.ResultsIn total 98 CE examinations were performed. There were 3 stomach retentions, therefore 95 cases were analysed. Indications were:1. SB bleeding (n = 53);2. suspected SB inflammation or reassessment of known inflammatory bowel disease (IBD) (n = 28);3. suspected SB malignancy (n = 8) and4. others (n = 6).The findings for each group are as follows:1. 14/53 (26.4%) patients had differences in findings between L/R heads. The differences changed diagnosis in 6 (11.3%) patients.2. 12/28 (42.9%) patients had differences between L/R heads, which changed diagnosis in 4 (14.3%) patients.3. 1/8 (12.5%) patient had differences between L/R heads which changed the diagnosis in this patient.Overall, use of two CE heads impacted the diagnosis in 11/95 (11.6%) of cases in our cohort.ConclusionsConventional single-headed CE has a relatively high proportion of negative examinations, often leading to multiple and repeated investigations in patients referred for suspected SB pathology.Use of double-headed CE provides more information which has potential to change clinical diagnosis and therefore management.

AB - AimsCapsule endoscopy (CE) is a well-established mode of investigation for small bowel (SB) pathology. This study aims to characterise the potential benefits of using double-headed capsules (vs conventional single-headed ones) in a real-world cohort of patients referred for CE. We present initial results from a single centre as part of a multicentre British study.MethodsOver a 9-month study period, patients referred for routine SBCE at a tertiary referral centre underwent double-headed CE in lieu of conventional single-headed CE. Clinical data were anonymised. One head (left or right) was chosen at random and reported by an expert reviewer. After an interval of 4 weeks, the other heads, also anonymised and in random order, were read and reported by the same reviewer. For each CE examination, the numbers and types of findings, and overall conclusion/diagnosis were compared between L/R heads.ResultsIn total 98 CE examinations were performed. There were 3 stomach retentions, therefore 95 cases were analysed. Indications were:1. SB bleeding (n = 53);2. suspected SB inflammation or reassessment of known inflammatory bowel disease (IBD) (n = 28);3. suspected SB malignancy (n = 8) and4. others (n = 6).The findings for each group are as follows:1. 14/53 (26.4%) patients had differences in findings between L/R heads. The differences changed diagnosis in 6 (11.3%) patients.2. 12/28 (42.9%) patients had differences between L/R heads, which changed diagnosis in 4 (14.3%) patients.3. 1/8 (12.5%) patient had differences between L/R heads which changed the diagnosis in this patient.Overall, use of two CE heads impacted the diagnosis in 11/95 (11.6%) of cases in our cohort.ConclusionsConventional single-headed CE has a relatively high proportion of negative examinations, often leading to multiple and repeated investigations in patients referred for suspected SB pathology.Use of double-headed CE provides more information which has potential to change clinical diagnosis and therefore management.

U2 - 10.1055/s-0039-1681195

DO - 10.1055/s-0039-1681195

M3 - Meeting Abstract

VL - 51

JO - Endoscopy

JF - Endoscopy

SN - 0013-726X

IS - 04

M1 - S9

ER -