PREDICTION OF CAPSULE ENDOSCOPY RETENTION USING PATENCY CAPSULE COMPARED TO MAGNETIC RESONANCE ENTEROGRAPHY IN KNOWN CROHN´S DISEASE PATIENTS

Aims Capsule endoscopy (CE) retention is as high as 13% in patients with Crohn’s disease (CD). Magnetic resonance enterography (MRE) and patency capsule (PC) are two useful tools for identifying strictures in small bowel (SB). The aim of this study is to compare the efficacy and safety of PC and RME for preventing CE retention in patients with CD.

Methods This is a prospective, comparative and observational study that included patients with known CD. All the patients underwent MRE and PC. If the PC was not retain CE was administered, but when it was retain, a double balloon enteroscopy was realized searching for the stricture. Predictive criteria for possible CE retention with MRE were long stricture (≥10 cm) or prestenotic dilatation ≥3 cm; and with PC were radiological evidence of PC in SB after 30 hours of the ingestion, excretion of a disintegrated PC or obstructive symptoms during PC passage. Retention was defined as a CE lodged in SB for >14 days or when DBE found a stricture with a diameter < 10 mm. Sensibility, specificity, positive predictive value (PPV), negative predictive value (NPV) and Kappa coefficient of PC and MRE were calculated.

Results 30 patients were included (19 female, 55 ±13.81 years old). Retention criteria with CE/DBE were found in 6 patients, agreeing in 5 cases with PC and in 4 with MRE. Sensibility, specificity, VPP and VPN of PC for CE retention were 83%, 100%, 100% and 96%, and of RME were 67%, 92%, 67% and 92%, respectively. Kappa coefficient for retention between PC and CE/DBE was of 0.889 and between MRE and CE/DBE was 0.583. One patient had obstructive symptoms with the PC that resolved spontaneously within 24 hours.

Conclusions PC is a safe and effective procedure for the prevention of CE retention in patients with known CD.