Endoscopy 2019; 51(04): S9
DOI: 10.1055/s-0039-1681195
ESGE Days 2019 oral presentations
Friday, April 5, 2019 08:30 – 10:30: Capsule 1 Club B
Georg Thieme Verlag KG Stuttgart · New York

DOUBLE-HEADED SMALL BOWEL CAPSULE ENDOSCOPY: REAL-WORLD EXPERIENCE AT A TERTIARY REFERRAL CENTRE

DE Yung
1   Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
,
S Douglas
1   Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
,
J Brzeszczynska
2   University of Edinburgh, Edinburgh, United Kingdom
,
JN Plevris
1   Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
2   University of Edinburgh, Edinburgh, United Kingdom
,
A Koulaouzidis
1   Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

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.