胶囊内镜临床应用新进展

Characteristics of the small intestine revealed by capsule endoscopy in 53 patients with gastrointestinal disorders

AIM: To analyze the characteristics of the small intestine of patients with gastrointestinal disorders by capsule endoscopy.

METHODS: Fifty-three patients who underwent MiroCam capsule endoscopy from August 2010 to August 2011 were included in the study. According to clinical data, the patients were classified as having obscure gastrointestinal bleeding, suspected functional gastrointestinal disease, abdominal pain, diarrhea, and abdominal distension. The characteristics of the normal or abnormal small bowel were analyzed.

RESULTS: Of 53 patients, one failed capsule endoscopy due to the absence of signal, and one could not successfully complete the examination procedure for personal reason. The capsule endoscope reached the colon in the remaining 51 cases (96.22%). The average time for the passage of the capsule endoscope to the stomach and small intestine is 69.78 and 513.25 min, respectively. Capsule endoscopy revealed abnormal changes in 48 cases, and the positive rate is 90.57%. For all 51 patients with suspected small bowel disease, the overall positive diagnosis rate of intestinal lesions was 92.15% (47/51), and that of jejunal and ileal lesions was 52.94%, including 12 cases of non-specific inflammation (1 patient diagnosed with Crohn's disease), 3 cases of polyps, 3 cases of unknown mass, 1 case of hyperplasia of lymphoid follicles, 7 cases of intestinal lymphangiectasia, and 1 case of hookworm disease. In addition, 1 case of of reflux esophagitis, 26 cases of chronic gastritis, 7 cases of erosive gastritis, 3 cases of stomach polyps, 5 cases of colon polyps, 3 cases of colitis, and 2 cases of colon melanosis were found. Capsules were removed from the body naturally, and no complications such as obstruction occurred.

CONCLUSION: MiroCam capsule endoscopy is a safe and non-invasive means of revealing small intestinal lesions.

Use of capsule endoscopy to diagnose colon diseases

AIM: To explore the use of capsule endoscopy to detect colon disorders following the completion of small intestine disease diagnosis on the basis of implementation of energy consumption control for the endoscope, body position adjustment and food serving.

METHODS: Seventy-six patients who received capsule endoscopy examination to exclude ileus were divided into two study groups: Group 1 (n = 39) and Group 2 (n = 37). Patients in Group 1 were examined by ordinary procedures. In contrast, patients in Group 2 were examined by modified procedures. The endoscope was manipulated to reduce the frequency of photographing and the brightness of endoscopic image before the capsule reached the duodenum. Within two hours after the capsule traveled inside the duodenum, the position of the moving capsule was observed continuously while the patient's body position was adjusted. The patients were laid flat with buttocks slightly elevated when the capsule moved into the colon. Meanwhile, the patients were served with food. When the capsule reached the hepatic flexure, the patients were laid on their left side. When the capsule reached the splenic flexure, the patients were laid in flat position. After the capsule battery was exhausted, the recorder was retrieved. The position of the capsule inside the patient's body was examined by X-ray.

RESULTS: Endoscopic capsules worked for 4 ± 0.9 h in the colon in Group 1. The capsules reached the recta in only four cases, and remained in the ileocecus in the other 35 cases, of which two cases of ileocecal polypi were detected. In contrast, endoscopic capsules worked for 5 ± 0.7 h in the colon in Group 2. The movement inside the colon was active after the patients took food. The capsules reached beyond the colon ascendens in 19 (51.4%) cases. Seven (18.9%) cases of colon diseases were detected in Group 2. Statistical differences were noted in the detection rate of colon diseases and the working duration of endoscopic capsules between the two groups (both P < 0.05). Moreover, a significant difference was observed in the effective rate of colon detection between the two groups (P < 0.01).

CONCLUSION: Implementation of battery energy control, patient position adjustment, and food serving during capsule endoscopy can effectively prolong the working duration of endoscopic capsules in the colon and increase the detection rate of colon diseases.