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.
