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.
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 language | English |
|---|---|
| Article number | S9 |
| Journal | Endoscopy |
| Volume | 51 |
| Issue number | 04 |
| DOIs | |
| Publication status | E-pub ahead of print - 18 Mar 2019 |
| Externally published | Yes |