One More Capsule: Profitability of Repeating Studies with Capsule Endoscopy

Aims To evaluate the usefulness of a repeat VCE, as related to initial findings and their management.

Methods A descriptive retrospective study was performed analyzing all patients studied with more than one Medtronic SB3 VCE in our center between January 2019 and December 2023. Endoscopic, clinical and management parameters were analyzed.

Results 56 VCE were performed on 27 patients. The mean age was 55.18 years. The majority of patients were male (62.96%). The main indication was anemia in those aged≥65 years and suspicion of IBD in those aged<65, in addition to anemia and HDOO in men (Table 1 and 2).

Table 3.1 we present the most relevant cases collected.

In 18.52% of cases, the repeat VCE was prompted by an incomplete first examination; of these, all of them but one were complete (gastric by-pass). 92.6% of repeat examinations took place in≤24 months, and 48.14% in≤12 months. 55.55% of patients received both VCEs for the same indication. Of these, when the indication was diagnostic (diarrhea, suspected IBD, anemia and obscure gastrointestinal bleeding, 66.66% in total), 70% turned out findings that were equivalent to the index examination. In 29.63% of cases, findings in the first VCE did not prompt a change in management, and in 62.5% of these patients, the repeat exploration did not return new relevant information. (Table 3).

Conclusions A repeat VCE did not yield relevant information in a majority of cases, excepting those ordered for the follow-up of small bowel specific pathologies. Besides, in a high percentage of cases, the ordering of a second VCE did not prompt a change in clinical management. This should encourage reflection on the repeated ordering of this test, particularly considering its high cost and lack of practical impact on management in these particular cases.

Publication History

Article published online:
27 March 2025