Aims:
Colon capsule is a non-invasive device primarily designed for colonic visualization.
However, a slight modification of the ingestion protocol may allow both the visualization
of the small bowel and colon with only one prep and one capsule.
This pan-enteroscopic study might be useful for those patients who may have pathology
in the small and large intestine (for instance in Peutz Jeghers syndrome) but also
for those patients with gastrointestinal bleeding who are high-risk patients for anesthesia
or for endoscopy.
Methods:
We have included all pan-enteroscopic capsule procedures performed in our unit, from
October 2011 to January 2015. We have focused on patients with a previous negative
gastroscopy. All patients prepared with PEG in split dose (2 liters+2 liters) and
sodium phosphate as capsule booster (30 ml+15 ml).
Results:
68 patients were submitted to a pan-enteric capsule study. 62.7% male with a mean
age of 72 years. The reason for referral was occult-obscure gastrointestinal bleeding
(OGIB) in 29.8% of cases, and 70.2% were high-risk patients for anesthesia/endoscopy.
31 (46.26%) had a negative gastroscopy and we found small bowel lesions in 67% and
colonic findings in 80.6% of them. According to the findings in the panendoscopic
study with capsule endoscopy in patients with negative EGD, in 64.5% of cases no other
endoscopic studies would be needed.
Despite of having several cardiac patients and patients with renal insufficiency,
no abnormalities were detected in renal function.
Conclusions:
A pan-enteroscopic capsule after a negative EGD may avoid further endoscopic studies
in 64.5% of cases.
The pan-enteroscopic capsule is a relatively safe procedure, with no effect on renal
function despite the use of sodium phosphate in high-risk patients.
