ABSTRACT
Small-bowel capsule endoscopy has been widely used in clinical practice and become the first-line method for diagnosing of small - bowel disorders. In order to standardize the examination procedure of small - bowel capsule endoscopy, clarify the indications and contraindications, on the basis of clinical practice in China, National Clinical Research Center for Digestive Diseases (Shanghai), National Digestive Endoscopy Improvement System, Capsule Endoscopy Collaborative Group of Chinese Society of Digestive Endoscopology, and Capsule Endoscopy Group of Digestive Endoscopy Branch of Shanghai Medical Association organized domestic experts in relevant fields to search and discuss relevant literatures at home and abroad. The quality of evidence and strength of recommendations were rated using the grading of recommendations assessment, development, and evaluation (GRADE) method. The reporting items for practice guidelines in healthcare (RIGHT) were followed to develop this guideline for providing guidance and decision-making basis for Chinese physicians.
ABSTRACT
Crohn's disease (CD) has the characteristics of jumping and transmural inflammation of the whole digestive tract. At present, the first-line examination methods to assist the diagnosis and treatment of CD are endoscopy, magnetic resonance enterography (MRE) and computed tomography enterography (CTE). However, due to the special anatomical structure of small intestine, the traditional endoscopic examination has limitations. MRE and CTE are sensitive to intestinal wall inflammation, but not to mucosal surface inflammation, which makes the difficulty of early diagnosis and treatment of small intestinal CD. Small bowel capsule endoscopy (SBCE) has solved this problem. This article reviewed the application of SBCE for the diagnosis and treatment of CD.
ABSTRACT
Background:Small bowel capsule endoscopy(SBCE)has become a first-line procedure for examining small bowel diseases. Aims:To evaluate the diagnostic value of SBCE in patients with mid-gastrointestinal bleeding(MGIB). Methods:MGIB patients who underwent SBCE from Jan. 2012 to Dec. 2014 at the Third People’s Hospital of Bengbu were enrolled. Diagnostic value of SBCE in MGIB was analyzed. Re-bleeding was followed up by outpatient visit and telephone. Results:Forty-four consecutive MGIB patients underwent SBCE procedures,the detection rate was 95. 5% and the positive rate was 65. 9% . Vascular abnormality(37. 9% ),inflammation(31. 0% )and tumor(20. 7% )were the three major etiology in SBCE positive patients. Follow-up results showed that re-bleeding rate in SBCE positive group was significantly higher than in non-positive group(41. 4% vs. 13. 3% ,P < 0. 05). Conclusions:Vascular abnormality is still the most major etiology of MGIB,meanwhile the proportions of inflammation and tumor are increasing. SBCE has a high detection rate and positive rate in initial screening of MGIB,and the risk of re-bleeding in patients with negative SBCE is low.
ABSTRACT
Crohn's disease (CD) is an inflammatory bowel disease that can affect the entire gastrointestinal tract, with the small bowel (SB) being the most commonly affected site. In some patients, refractory inflammation or chronic strictures of the SB are responsible for a debilitating course of the disease that might lead to severely reduced quality of life. Therefore, SB imaging is a crucial element in diagnosing and/or managing SB CD, and continues to evolve because of technologic advances. SB endoscopy (capsule endoscopy and device-assisted enteroscopy) and cross-sectional radiologic imaging (computed tomography enterography and magnetic resonance enterography) have become key players to diagnose and/or manage CD. In everyday practice, the choice of the imaging modalities is based on the presence and availability of the techniques and of experienced operators in each institute, clinical usefulness, safety, and cost. Here, SB endoscopy and radiologic imaging in suspected or known CD patients will be addressed and discussed.