Reaching hidden depths. A correlation between small bowel capsule endoscopy transit and depth of insertion on anterograde device assisted enteroscopy

Aims Capsule endoscopy (SBCE) and device assisted enteroscopy (DAE) are complementary tools for small bowel disease management. A better understanding of the correlation between time based location on SBCE and DAE distance would be useful for planning intervention. We aim to correlate predicted distance on DAE with transit based location at SBCE.

Methods A retrospective single centre comparison study. Cases with a SBCE after an anterograde DAE (single or double balloon) with a visible distal limit of insertion tattoo on capsule review were included. Transit time (TT), location of the tattoo as a % of the TT (%TT), DAE cycles and distance traversed to the tattoos were recorded and compared.

Results 56 cases were identified, in 42 (74%), the tattoo was visible on capsule review. Median time to SBCE was 12 weeks (0–174). The median recorded tattoo depth on DAE was 200cm (45cm–400) with a median of 5 cycles (1–13). Median TT was 248min (42min–625min). Median %TT was 14% (75%–0.15%), >33 %TT was achieved in 26% (12/42) of cases. There was no correlation between DAE distance and %TT on SBCE (r= -0.216, p=0.17). In general, the percentage small bowel transit estimated at DAE was significantly less that that documented on SBCE (p<0.001) mean (2.87% v 20.71%, respectively,).

Conclusions DAE underestimates the depth of insertion compared to capsule transit. Our data suggests lesions within 33% TT are readily amenable to ADAE, with a much deeper range possible, than previously considered.

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Artikel online veröffentlicht:
14. April 2023