Exploring the Interior: Indications and Diagnostic Yield of Capsule Endoscopy and Follow-Up Management of Its Findings

Aims To define indications, DY and management of VCE findings.

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

Results 351 VCE were ordered, with 67 Patency capsules (PC) performed. 11 of the latter were deteriorated and a final number of 340 VCE were performed and analyzed for this study. The mean age was 54.07 years. 27% of patients were≥65 years of age, with a 55% predominance of female patients. 96% of VCEs were complete. Out of these, 52% returned findings pertinent to the clinical question, with a 7% rate of incidental findings in this group. Within the 48% of VCEs without findings related to the indication, there was a 9% rate of incidental findings. Figures 1, 2 and 3 reflect indications, management, and DY paired with the rate of cases in which management changes were motivated by VCE findings. 4 patients required surgical management: 1 ischemic anastomotic ulcers, 1 Meckel’s diverticulum and 2 ulcerated submucosal lesions (1 lipoma and 1 pyloric gland adenoma). 3 cases were retained, with 2 of them underwent PC and came through the procedure intact, with a difference of 8 and 34 days between capsules. The 3 patients had IBD. 2 of these patients were successfully managed conservatively, while 1 required corticosteroid.

Conclusions Our study has an acceptable DY. Findings support prioritizing indications with a higher probability of positive findings, such as anemia or suspected IBD. On the other hand, DY was extremely low in VCEs ordered for the study of diarrhea without a firm suspicion for IBD. Even in cases when positive findings pertinent to the clinical question were found, did not exhibit a change in attitude. This observation prompts a critical evaluation of the utilization os this test. VCE is safe, even in patients with IBD who have the highest risk of retention, in which the time interval between PC and VCE should be optimized.

Publication History

Article published online:
27 March 2025