A single centre analysis of small bowel endoscopy: completeness of procedure and pathology detection

Aims Video Capsule Endoscopy (VCE) is a non-invasive diagnostic tool used to visualise the gastrointestinal tract. It is the first line in investigating small bowel pathology and bleeding. We have performed a retrospective analysis of VCE performed in a tertiary centre for the past three years.

Methods The list of patients who had VCE performed for the past three years was obtained from the endoscopy department. Data was collctected from the VCE report and from iPortal. We analysed the demographics, indication, pathology detected, quality of bowel preparation, and follow-up procedure.

Results 184 cases were included with 50% (n=92) males. Median age was 57 with the range between 25 to 83. In terms of indication, 59.2% (n=103) were as 2 week-wait referrals, 44% (n=81) were extension surveillance. The Faecal Immunochemical Test (FIT) was positive in 35.9%. There were 4.89% (n=9) incomplete procedures. 56% of them (n=5) were unable to assess due to capsule endoscopy not passed. 33% had inadequate view to assess the colon due to inadequate bowel preparation. One patient vomited the capsule 3 hours after ingestion. In terms of outcome for this group, 5 were referred for colonoscopy, 2 for Computed Tomography (CT) colonoscopy, 1 for flexible sigmoidoscopy for completion, 1 was discharged. The capsule retention rate was 2.72%. The group of patients who had retained capsules had a colonoscopy for both retrieval and diagnostic purposes. 71.2% (n=131) had pathology detected. 39.1% (n=72) had diverticulosis, 25.5% (n=47) had angioectasia, 3.3% (n=6) had mucosal inflammation, 2% (n=4) had lymphangiectasia, 1.6% (n=3) had gastritis, 1.6% (n=3) had aphthous ulcer, 1% (n=2) had oesophagitis, 1% (n=2) had lipoma, 1% (n=2) had pseudopolyp, 1% (n=2) had Barret’s oesophagus, 1% (n=2) had gastric polyp, 0.5% (n=1) had altered blood in gastric fold, 0.5% (n=1) had chylous cyst, 0.5% (n=1) had flat lesion in small bowel, 0.5% (n=1) had Gastric Antral Vascular Ectasia (GAVE) an 0.5% (n=1) had lipoma [1]. In terms of polyp detection, 60.3% (n=111) have polyps detected.

Conclusions Our data suggest we have a high percentage of complete procedure (94.6%) and pathology detection (71.2%), All of which was above the performance measures set out by the European Society of Gastrointestinal Endoscopy (ESGE) [2]. Our capsule retention rate was 2.72% which was just above the international target standard (2%) [2].

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

• 1 de Sousa Magalhães R, Arieira C, Boal Carvalho P, Rosa B, Moreira MJ, Cotter J.. Colon Capsule CLEansing Assessment and Report (CC-CLEAR): a new approach for evaluation of the quality of bowel preparation in capsule colonoscopy. Gastrointest Endosc 2021; 93 (1): 212-223 Epub 2020 Jun 11. PMID: 32534054
• 2 Spada C, McNamara D, Despott EJ, Adler S, Cash BD, Fernández-Urién I, Ivekovic H, Keuchel M, McAlindon M, Saurin JC, Panter S, Bellisario C, Minozzi S, Senore C, Bennett C, Bretthauer M, Dinis-Ribeiro M, Domagk D, Hassan C, Kaminski MF, Rees CJ, Valori R, Bisschops R, Rutter MD.. Performance measures for small-bowel endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2019; 51 (6): 574-598 Epub 2019 May 10. PMID: 31075800