INCOMPLETE CAPSULE ENDOSCOPY: DOES IT MATTER?

Aims:

In up to 30% of capsule endoscopy (CE) procedures, the capsule failed to reach the cecum resulting into incomplete CE. This may limit the value of CE. Various risk factors such as gastric transit time, prior small bowel surgery and hospitalization were identified as independent risk factors for incomplete CE. We aimed to study clinical impact of incomplete CE.

Methods:

The medical records of the patients from Jan 2003 to Feb 2017, who underwent capsule endoscopy at Asian Institute of Gastroenterology, Hyderabad, India were reviewed. Out of which patients who had incomplete CE were evaluated for positive or negative results in visualized small bowel. In the patients with negative and incomplete CE; final diagnosis was reviewed.

Results:

Out of the total 1523 CE during study period, 172 (11.29%) capsule did not reached cecum. 76.7% (132 of 172) CE were performed for obscure GI bleed, while 15.7% (27 of 172) were for known or suspected CD and remaining 13 were performed for abdominal pain. In 114 (66.3%) CE was reported as positive depending upon findings of visualized small bowel, remaining 58 (33.7%) were reported as negative and incomplete. Out of these 58 patients, 6 patients had follow-up of less than 6 months. In remaining 52 patients, CE missed diagnosis in 22 (1.4% of 1523) patients which was established by either enteroscopy or diagnostic laparoscopy and intra-operative enteroscopy in the follow-up.

Conclusions:

Though significant number of CE results in incomplete CE, its overall impact may not be alarming.