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1.
Gastroenterol Hepatol ; : 502223, 2024 Jun 20.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38908683

RESUMO

OBJECTIVES: To search for parameters susceptible to optimization when performing capsule endoscopy (CE) in a third level hospital with high volume and experience in this test. PATIENTS AND METHODS: Retrospective observational study, including 1325 CEs performed between 2017 and 2022. Overall diagnostic yield, effective diagnostic yield, by indication, place of request and waiting list, as well as complete examination rate and cleansing degree were analyzed. RESULTS: The overall diagnostic yield was 70.99%, while the effective diagnostic yield was 72.7%. Diagnostic yields varied between 60.2% and 77.9% depending on the indication and between 64.7% and 74.3% depending on the requesting center. The mean waiting list was 101.15 days, with a tendency to worse results when the waiting list was longer. A total of 77.8% of the examinations were complete. Completion rates were lower in patients >70 years of age (p=0.001), as well as in those with gastric transit >60minutes (p=0.000). A total of 77.3% were clean, with debris that did not impede diagnosis being found in 16.9% and debris that did impede diagnosis in 5.8%. There was a relationship, although not significant, between cleansing degree and age. CONCLUSIONS: The diagnostic yields of CE in our center are in line with those previously reported. Differences were found according to the place of request. Waiting list could also influence diagnostic yield. Completion rates are lower in >70 years of age and when gastric transit is >60minutes. Cleansing degree achieved is acceptable.

2.
Rev. esp. enferm. dig ; 115(12): 750-751, Dic. 2023. ilus
Artigo em Inglês, Espanhol | IBECS | ID: ibc-228740

RESUMO

Melanoma is a cancer that frequently metastasises to the small bowel, but most cases are asymptomatic and are diagnosed postmortem. Therefore, CT and PET CT cannot detect all lesions and conventional endoscopic study only detects 10-20% of lesions. In this study, we present the case of a 68-year-old patient with a history of cutaneous melanoma and a diagnosis of intestinal melanoma. Thanks to capsule endoscopy, two lesions compatible with cutaneous melanoma metastasis to the small bowel were detected, allowing a much more effective surgical planning. Capsule endoscopy is an innovative technique that improves preoperative diagnosis, as it is able to detect bowel segments that cannot be inspected by conventional endoscopy. It also has a better resolution than conventional CT, improving sensitivity in the detection of lesions.(AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Cápsulas Endoscópicas , Intestino Delgado , Melanoma/diagnóstico por imagem , Endoscopia Gastrointestinal , Neoplasias Intestinais/cirurgia , Pacientes Internados , Exame Físico , Resultado do Tratamento
3.
Rev. gastroenterol. Perú ; 43(1)ene. 2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1441882

RESUMO

Se presentan dos pacientes con diarrea crónica, con múltiples estudios negativos, y que tenían en común la deficiencia de vitamina B12. Ambos pacientes tenían estudios repetitivos de parásitos en heces negativos. Sólo al realizarse colonoscopía en el primer caso y la cápsula endoscópica en el segundo, se pudo diagnosticar formas adultas de Diphyllobotrium spp. Luego del tratamiento antiparasitario, ambos pacientes remitieron completamente sus síntomas.


We present two patients with chronic diarrhea, with multiple negative studies, both had in common vitamin B12 deficiency. Both patients had multiple studies of parasites in negative stool. Only after colonoscopy in the first case and capsule endoscopy in the second case, it was possible to diagnose the adult forms of Diphyllobotrium spp. After treatment, both patients completely resolved their symptoms.

4.
Rev Gastroenterol Mex (Engl Ed) ; 88(2): 132-135, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34903483

RESUMO

INTRODUCTION AND AIMS: The patency capsule is an effective diagnostic method for preventing video capsule retention in the small bowel during capsule endoscopy. The most frequently associated complication when using the patency capsule is symptomatic retention. The aim of the present study was to evaluate the effectiveness and safety of patency capsules administered to patients at a tertiary care hospital center. MATERIALS AND METHODS: A retrospective observational study was conducted that included all the patients with confirmed Crohn's disease that were administered a patency capsule, within the time frame of January 2019 and December 2020. PC diagnostic yield, sensitivity, specificity, positive predictive value, and negative predictive value were evaluated, in relation to capsule endoscopy and double-balloon endoscopy findings. Complications associated with the patency capsule were also identified. RESULTS: Thirty patients were included, in whom the patency capsule had 83% sensitivity, 100% specificity, 100% positive predictive value, and 96% negative predictive value, with a diagnostic yield of 96.7%. There was one complication (3.3%) and it resolved spontaneously. CONCLUSIONS: The patency capsule is a safe and effective method for reducing video capsule retention during capsule endoscopy in patients with Crohn's disease.


Assuntos
Endoscopia por Cápsula , Doença de Crohn , Humanos , Doença de Crohn/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Endoscopia por Cápsula/efeitos adversos , Valor Preditivo dos Testes , Estudos Retrospectivos
5.
Gastroenterol. latinoam ; 34(2): 61-65, 2023. ilus
Artigo em Espanhol | LILACS | ID: biblio-1524718

RESUMO

We report a clinical case from a patient with alcoholic cirrhosis who had chronic anemia and carried out several endoscopic studies without evidence of active bleeding, a complementary study with endoscopic capsule was requested to search for a source of bleeding. In the analysis of laboratory data, the presence of hypereosinophilia stands out in parallel. The images obtained in the video capsule study show geoparasites helminth-type. After parasite treatment, anemia improves and the absolute eosinophil count is normalized.


Reportamos el caso de un paciente cirrótico por alcohol con anemia crónica quien se realizó varios estudios endoscópicos sin evidencia de sangrado activo, por tal motivo se solicitó estudio complementario con cápsula endoscópica para búsqueda de fuente de sangrado. En el análisis de los datos de laboratorio paralelamente destaca la presencia de hipereosinofilia. Las imágenes obtenidas en el estudio de la video cápsula muestran varios geoparásitos de tipo helmintos. Posterior al tratamiento antiparasitario mejora la anemia y se normaliza el recuento absoluto de eosinófilos.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Endoscopia por Cápsula , Hemorragia Gastrointestinal/etiologia , Enteropatias Parasitárias/diagnóstico , Eosinofilia/etiologia , Hemorragia Gastrointestinal/diagnóstico , Anemia/etiologia , Enteropatias Parasitárias/complicações , Enteropatias Parasitárias/tratamento farmacológico , Intestinos/parasitologia , Cirrose Hepática/complicações , Antiparasitários/uso terapêutico
7.
Rev. esp. enferm. dig ; 114(12): 762-763, diciembre 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-213548

RESUMO

La linfangiectasia intestinal primaria es un trastorno raro asociado a una enteropatía pierde-proteínas. Las principales manifestaciones son las derivadas de la hipoalbuminemia. Para lograr el diagnóstico se necesita la imagen endoscópica típica de la linfangiectasia intestinal y el aumento de las cifras de alfa-1-antitripsina en las heces de 24 horas. El tratamiento es básicamente dietético. (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Hipoalbuminemia , Edema , Linfangiectasia , Cápsulas Endoscópicas , Intestino Delgado
8.
Rev. colomb. gastroenterol ; 37(3): 330-333, jul.-set. 2022. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1408046

RESUMO

Resumen Las vasculitis sistémicas pueden llegar a afectar los vasos sanguíneos de todos los tamaños, provocando necrosis e inflamación. La granulomatosis con poliangitis (GPA) es una vasculitis de vasos pequeños y medianos. Las presentaciones clínicas pueden ser locales o difusas en el tracto gastrointestinal. Presentamos el caso de un paciente con diagnóstico de vasculitis sistémica asociada a anticuerpos anticitoplasma (ANCA) mieloperoxidasa (MPO) (poliangitis microscópica) confirmada con biopsia renal, con clínica de 15 días consistente en astenia, adinamia, oliguria subjetiva, edema de miembros superiores e inferiores, hiporexia y melenas. En el examen físico, el tacto rectal fue positivo para melenas, posteriormente presentó anemización secundaria a melenas, por lo que se realizó videocápsula endoscópica en la que se evidenciaron hallazgos compatibles con vasculitis entérica. Durante su estancia presentó compromiso multisistémico dado por la afectación renal, pulmonar, neurológica y gastrointestinal, manejada en la unidad de cuidados intensivos (UCI), donde se iniciaron pulsos de esteroide sistémico y hemodiálisis. Conclusión: la vasculitis gastrointestinal es una complicación rara; sin embargo, ocurre y causa una grave amenaza para la vida de los pacientes. El diagnóstico diferencial debe cubrir otras enfermedades inflamatorias, especialmente la enfermedad de Crohn. Su adecuado reconocimiento influencia de forma significativa el pronóstico, pues el inicio rápido de la terapia con esteroides puede cambiar el curso de la enfermedad.


Abstract Systemic vasculitis can affect blood vessels of all sizes, causing necrosis and inflammation. Granulomatosis with polyangiitis (GPA) is a vasculitis of small and medium blood vessels. Clinical manifestations may be local or diffuse in the gastrointestinal tract. We present a patient's case with systemic vasculitis associated with anti-cytoplasmic antibodies (ANCA), myeloperoxidase (MPO) antibodies (microscopic polyangiitis) confirmed through renal biopsy, presenting a 15-day clinical picture consisting of asthenia, adynamia, subjective oliguria, edema of the upper and lower limbs, hyporexia, and melena. The digital rectal examination was positive for melena in the physical examination, later presenting melena with secondary anemization. An endoscopic video capsule was performed, showing findings compatible with enteric vasculitis. During his stay, he presented multisystemic involvement due to renal, pulmonary, neurological, and gastrointestinal involvement, managed in the intensive care unit (ICU), where systemic steroid pulses and hemodialysis started. Conclusion: although gastrointestinal vasculitis is a rare complication, it occurs and threats patients' lives. Differential diagnosis should cover other inflammatory diseases, especially Crohn's disease. Gastrointestinal vasculitis early diagnosis significantly influences prognosis, as prompt steroid therapy can change the course of the disease.

9.
Rev. colomb. gastroenterol ; 37(1): 33-39, Jan.-Mar. 2022. tab, graf
Artigo em Inglês, Espanhol | LILACS | ID: biblio-1376903

RESUMO

Abstract Introduction: The prevalence of iron deficiency anemia in developed countries has been estimated between 2-5 %, associated with high morbidity and mortality. Etiological identification is sometimes difficult and requires diagnostic methods, such as video capsule endoscopy (VCE). Aim: This study intends to characterize the findings of this technique in patients with unexplained iron deficiency anemia. Materials and methods: Descriptive observational retrospective study. We describe the VCE findings (PillCamSB2-SB3) in all patients seen between 2011 and 2019. The findings were interpreted according to the Saurin classification: normal (P0), uncertain potential (P1), and high bleeding potential (P2). Results: Of the 490 VCEs performed during the study period, 155 indicated iron deficiency anemia; 106 were women (68.4 %), and the mean age was 57.1 ± 16.6 years. The main comorbidities were cardiovascular in 23 (18.3 %) and arterial hypertension in 16 (12.6 %). Antiplatelets were present in 18 (15.4 %) and anticoagulants in six (5.1 %). Small bowel lesions were vascular in 44 studies (28.4 %), inflammatory in 33 (21.2 %), and neoplastic in seven (4.5 %). Angiectasias were the most frequent lesions in 33 cases (21.3 %). P2 lesions were present in 53 VCEs (34.2 %). Conclusions: VCE is helpful in the study of iron deficiency anemia and helps detect positive findings in the midgut in three out of four patients for which it is indicated. The most frequent significant P2 lesions were vascular. These findings allow providing adequate treatment.


Resumen Introducción: la prevalencia de la anemia ferropénica en países desarrollados se ha estimado entre 2 %-5 %, asociada con una alta morbimortalidad. La identificación etiológica a veces es difícil, y requiere de métodos diagnósticos, como la videocápsula endoscópica (VCE). Objetivo: el objeto del presente estudio fue caracterizar los hallazgos de esta técnica en pacientes con anemia ferropénica inexplicada. Materiales y métodos: estudio descriptivo, observacional y retrospectivo. Se describen los hallazgos de VCE (PillCamSB2-SB3) en todos los pacientes atendidos entre 2011 y 2019. Los hallazgos se interpretaron según la clasificación de Saurin: normal (P0), potencial incierto (P1) y alto potencial de sangrado (P2). Resultados: del total de 490 VCE realizadas durante el período del estudio, 155 se efectuaron con indicación de anemia ferropénica; 106 fueron mujeres (68,4 %) y la edad media fue de 57,1 ± 16,6 años. Las comorbilidades principales fueron cardiovasculares en 23 (18,3 %) e hipertensión arterial en 16 (12,6 %). La ingesta de antiplaquetarios se presentó en 18 (15,4 %) y anticoagulantes en 6 (5,1 %). Las lesiones en el intestino delgado fueron vasculares en 44 estudios (28,4 %), inflamatorias en 33 (21,2 %) y neoplásicas en 7 (4,5 %). Las angiectasias fueron las lesiones más frecuentes en 33 casos (21,3 %). En 53 VCE se presentaron lesiones P2 (34,2 %). Conclusiones: la VCE es útil en el estudio de la anemia ferropénica, y ayuda a detectar hallazgos positivos en el intestino medio en 3 de cada 4 pacientes en los cuales se indica su uso. Las lesiones P2 significativas más frecuentes fueron las vasculares. Estos hallazgos permiten enfocar un tratamiento adecuado.


Assuntos
Humanos , Masculino , Feminino , Anemia Ferropriva , Endoscopia por Cápsula , Intestino Delgado , Pacientes , Estudos Retrospectivos , Hemorragia , Anticoagulantes
10.
Gastroenterol. hepatol. (Ed. impr.) ; 44(10): 680-686, Dic. 2021. tab, ilus, graf
Artigo em Inglês | IBECS | ID: ibc-222069

RESUMO

Background: Small Bowel Capsule Endoscopy is the first-choice technique for investigating the majority of small bowel diseases. Its most common complications are related to incomplete examinations and capsule retention. There is no consensus on how patients with previous gastrointestinal surgery should receive the capsule. Objective: The primary endpoint was to compare the rate of complete small-bowel examinations (completion rate) between oral ingestion and endoscopic delivery of the capsule. The secondary endpoint was to compare diagnostic yield and adverse events in the two groups. Methods: A retrospective observational study was conducted in nine hospitals in Spain. Demographic data, previous surgery, indication for capsule endoscopy, intestinal transit time, diagnosis, completion rate (percentage of capsules reaching the caecum), diagnostic yield (percentage of results compatible with indication for the exam) and adverse events were collected. Results: From January 2009 to May 2019 fifty-seven patients were included (39 male, mean age 66±15 years). The most common indications for the exam were “overt” (50.9%) and “occult” (35.1%) small bowel bleeding. Previous Billroth II gastrectomy and Roux-en-Y gastric bypass were present in 52.6% and 17.5% of patients respectively. The capsule was swallowed in 34 patients and placed endoscopically in 23 patients. No significant differences were observed between the oral ingestion and endoscopic delivery groups in terms of completion rate (82.4% vs. 78.3%; p=0.742), diagnostic yield (41.2% vs. 52.2%; p=0.432) or small bowel transit time (301 vs. 377min, p=0.118). No capsule retention occurred. Only one severe adverse event (anastomotic perforation) was observed in the endoscopic delivery group. Conclusions: In our case series, there were no significant differences between oral ingestion and endoscopic delivery in terms of completion rate, diagnostic yield or safety.(AU)


Antecedentes: La cápsula endoscópica representa la técnica de primera elección para investigar la mayoría de las enfermedades del intestino delgado. Sus complicaciones más comunes frecuentes son las exploraciones incompletas y la retención a nivel de intestino delgado. Hasta el momento no hay acuerdo sobre cómo administrar la cápsula a los pacientes que han sido sometidos a una cirugía gastrointestinal previa. Objetivo: El objetivo principal fue comparar la tasa de estudios completos entre la ingestión oral y la administración endoscópica de la cápsula. Los objetivos secundarios fueron comparar el rendimiento diagnóstico y los eventos adversos en ambos grupos. Métodos: Se realizó un estudio observacional retrospectivo en 9 hospitales de España. Se recogieron datos demográficos, cirugía previa, indicación de cápsula endoscópica, tiempo de tránsito intestinal, diagnóstico, tasa de estudios completos (porcentaje de cápsulas que llegan al ciego), rendimiento diagnóstico (porcentaje de resultados compatibles con la indicación del examen) y eventos adversos. Resultados: Desde enero de 2009 hasta mayo de 2019 se incluyeron 57 pacientes (39 hombres, edad media 66 ± 15 años). Las indicaciones más frecuentes para el examen fueron hemorragia de intestino delgado «manifiesta» (50,9%) y «oculta» (35,1%). El 52,6% de los pacientes presentaba gastrectomía Billroth II y el 17,5% bypass gástrico en Y de Roux. La cápsula fue ingerida en 34 pacientes y colocada endoscópicamente en 23 pacientes. No se observaron diferencias significativas entre los grupos de ingesta oral y de colocación endoscópica en cuanto a tasa de estudios completos (82,4% vs. 78,3%; p = 0,742), rendimiento diagnóstico (41,2% vs. 52,2%; p = 0,432) y tiempo de tránsito del intestino delgado (301 vs. 377 min, p = 0,118). No hubo casos de cápsulas retenidas. Solo se observó un evento adverso severo (perforación anastomótica) en el grupo de colocación endoscópica...(AU)


Assuntos
Humanos , Gastroscopia , Intestino Delgado , Endoscopia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Derivação Gástrica , Espanha , Gastroenterologia , Gastroenteropatias , Estudos Retrospectivos , Estudos de Coortes
11.
Gastroenterol. hepatol. (Ed. impr.) ; 44(10): 696-703, Dic. 2021. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-222071

RESUMO

Introducción: La cápsula endoscópica de intestino delgado (CEID) es una técnica diagnóstica poco invasiva cuyo empleo en la enfermedad inflamatoria intestinal (EII) se ha extendido. Se ha desarrollado recientemente una cápsula panentérica, PillCamCrohn's (PCC). Carecemos de información sobre la disponibilidad y el uso de la CEID y la PCC en nuestro medio. Métodos: Realizamos una encuesta electrónica y anónima entre los miembros del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa y la Asociación Española de Gastroenterología consistente en 37 preguntas de respuesta múltiple. Resultados: Participaron 150 miembros, la mayoría con dedicación especial a la EII (69,3%). El 72,8% trabajaban en centros con unidad de EII. El 79% tenían la CEID disponible en su hospital, y el 14% la derivaban a otro centro. El 22% tenían disponible la PCC, y el 9% la derivaban a otro centro. El 79,3% de encuestados con CEID disponible la utilizaban en un pequeño porcentaje de pacientes con EII y el 15,6% en la mayoría. Los escenarios más frecuentes fueron la sospecha de enfermedad de Crohn (76,3%), la valoración de actividad inflamatoria (54,7%) y la evaluación de la extensión de la enfermedad (54,7%). Más de la mitad (59,7%) utilizaban preferentemente la cápsula Patency® para valoración de la permeabilidad intestinal. Casi todos los encuestados (99,3%) consideraban que se deberían implementar recursos formativos en esta técnica. Conclusiones: La CEID cuenta con una amplia disponibilidad en los hospitales españoles para el manejo de la EII, si bien su uso es todavía limitado. Existe una oportunidad para aumentar la formación en esta técnica, y, con ella, su empleo.(AU)


Introduction: Small bowel capsule endoscopy (SBCE) is a non-invasive diagnostic technique whose use in inflammatory bowel disease (IBD) has spread. A panenteric capsule, PillCam Crohn's (PCC), has recently been developed. We lack information on the availability and use of the CEID and PCC in our environment. Methods: We conducted an electronic and anonymous survey among the members of the Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) [Spanish Working Group on Crohn's Disease and Ulcerative Colitis] and the Asociación Española de Gastroenterología (AEG) [Spanish Association of Gastroenterology], consisting of 37 multiple-choice questions. Results: One hundred and fifty members participated, the majority dedicated to IBD (69.3%). 72.8% worked at centres with an IBD unit. 79% had SBCE available at their hospital, 14% referred patients to another centre; 22% had a PCC available, 9% referred patients to another centre. 79.3% of respondents with available SBCE used it in a small percentage of patients with IBD and 15.6% in the majority. The most frequent scenarios were suspicion of Crohn's disease (76.3%), assessment of inflammatory activity (54.7%) and assessment of the extent of the disease (54.7%). More than half (59.7%) preferentially used the Patency capsule to assess intestinal patency. Almost all respondents (99.3%) considered that training resources should be implemented in this technique. Conclusions: SBCE is widely available in Spanish hospitals for the management of IBD, although its use is still limited. There is an opportunity to increase training in this technique, and consequently its use.(AU)


Assuntos
Humanos , Cápsulas Endoscópicas , Doenças Inflamatórias Intestinais , Intestino Delgado , Colite Ulcerativa , Doença de Crohn , Espanha , Inquéritos e Questionários , Gastroenterologia , Gastroenteropatias
12.
Rev Gastroenterol Mex (Engl Ed) ; 86(3): 215-219, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34210455

RESUMO

INTRODUCTION AND AIM: Graft-versus-host disease (GvHD) is a complication of hematopoietic cell transplantation, and the small bowel is one of the main targets in the gastrointestinal tract. Capsule endoscopy is a safe procedure and can be useful in the diagnosis of GvHD. The aim of the present study was to compare the diagnostic yield of capsule endoscopy with the histopathologic findings in GvHD. MATERIALS AND METHODS: A retrospective diagnostic test study included all the patients with suspected GvHD that underwent gastroscopy and colonoscopy, with histopathologic evaluation of the biopsies taken, and capsule endoscopy, within the time frame of July 2015 and July 2019. Capsule endoscopy findings were compared with the histopathologic diagnosis, considered the gold standard. RESULTS: Twenty-one patients with GvHD (7 [33%] women; 37 ± 11.9 years of age) were included, 20 (95%) of whom had acute GvHD. The median gastric transit time of the capsule was 55 minutes (20-113) and the median small bowel transit time was 261 minutes (238-434). The entire small bowel was visualized through capsule endoscopy in 17 cases (80.95%). The histopathologic findings and capsule endoscopy findings resulted in the diagnosis of GvHD in 17 and 16 cases, respectively. There was agreement between the histopathologic and capsule endoscopy findings in 18 cases (15 positive and 3 negative). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic yield of capsule endoscopy were 88%, 75%, 94%, 60%, and 85%, respectively. CONCLUSIONS: Capsule endoscopy is a safe tool for the diagnosis of GvHD, with high sensitivity and positive predictive value, as well as moderate agreement with histopathologic findings.


Assuntos
Endoscopia por Cápsula , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Feminino , Doença Enxerto-Hospedeiro/diagnóstico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Intestino Delgado/diagnóstico por imagem , Estudos Retrospectivos
13.
Gastroenterol Hepatol ; 44(10): 696-703, 2021 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33872625

RESUMO

INTRODUCTION: Small bowel capsule endoscopy (SBCE) is a non-invasive diagnostic technique whose use in inflammatory bowel disease (IBD) has spread. A panenteric capsule, PillCam Crohn's (PCC), has recently been developed. We lack information on the availability and use of the CEID and PCC in our environment. METHODS: We conducted an electronic and anonymous survey among the members of the Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa (GETECCU) [Spanish Working Group on Crohn's Disease and Ulcerative Colitis] and the Asociación Española de Gastroenterología (AEG) [Spanish Association of Gastroenterology], consisting of 37 multiple-choice questions. RESULTS: One hundred and fifty members participated, the majority dedicated to IBD (69.3%). 72.8% worked at centres with an IBD unit. 79% had SBCE available at their hospital, 14% referred patients to another centre; 22% had a PCC available, 9% referred patients to another centre. 79.3% of respondents with available SBCE used it in a small percentage of patients with IBD and 15.6% in the majority. The most frequent scenarios were suspicion of Crohn's disease (76.3%), assessment of inflammatory activity (54.7%) and assessment of the extent of the disease (54.7%). More than half (59.7%) preferentially used the Patency capsule to assess intestinal patency. Almost all respondents (99.3%) considered that training resources should be implemented in this technique. CONCLUSIONS: SBCE is widely available in Spanish hospitals for the management of IBD, although its use is still limited. There is an opportunity to increase training in this technique, and consequently its use.


Assuntos
Endoscopia por Cápsula/estatística & dados numéricos , Colite Ulcerativa/diagnóstico por imagem , Doença de Crohn/diagnóstico por imagem , Gastroenterologia/estatística & dados numéricos , Pesquisas sobre Atenção à Saúde/estatística & dados numéricos , Endoscopia por Cápsula/educação , Feminino , Gastroenterologia/educação , Humanos , Laxantes/administração & dosagem , Masculino , Sociedades Médicas , Espanha
14.
ARS med. (Santiago, En línea) ; 46(1): 34-37, mar. 2021.
Artigo em Inglês | LILACS | ID: biblio-1293293

RESUMO

The diagnosis of neuroendocrine tumors of the small intestine is usually challenging. They are infrequent, and the clinical course is insidious with nonspecific manifestations. Routine endoscopic and abdominal imaging studies are more often unremarkable. Therefore, distant metastases are frequently detected at the time of diagnosis. The tumor markers chromogranin A, synaptophysin, and neuron-specific enolase, and capsule endoscopy, and device-assisted enteroscopy are useful resources to establish a diagnosis. The aim was to present a case of neuroendocrine tumor of small intestine diagnosed with base in findings of the capsule endoscopy and further open surgery.


El diagnóstico de tumores neuroendocrinos del intestino delgado suele ser un desafío. Son infrecuentes y el curso clínico es insidioso con manifestaciones inespecíficas. Los estudios de imágenes endoscópicos y abdominales de rutina suelen ser anodinos. Por tanto, las metástasis a distancia se detectancon frecuencia en el momento del diagnóstico. Los marcadores tumorales cromogranina A, sinaptofi-sina y enolasa neuronal específica, y la cápsula endoscópica y la enteroscopía asistida por dispositivo son recursos útiles para establecer un diagnóstico. El objetivo de este trabajo fue presentar un caso de tumor neuroendocrino de intestino delgado diagnosticado con base en hallazgos de la cápsula endoscópica y de una nueva cirugía abierta.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Relatos de Casos , Tumores Neuroendócrinos , Endoscopia por Cápsula , Cirurgia Geral , Diagnóstico , Neoplasias Gastrointestinais , Intestino Delgado
15.
Gastroenterol Hepatol ; 44(10): 680-686, 2021 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33259828

RESUMO

BACKGROUND: Small Bowel Capsule Endoscopy is the first-choice technique for investigating the majority of small bowel diseases. Its most common complications are related to incomplete examinations and capsule retention. There is no consensus on how patients with previous gastrointestinal surgery should receive the capsule. OBJECTIVE: The primary endpoint was to compare the rate of complete small-bowel examinations (completion rate) between oral ingestion and endoscopic delivery of the capsule. The secondary endpoint was to compare diagnostic yield and adverse events in the two groups. METHODS: A retrospective observational study was conducted in nine hospitals in Spain. Demographic data, previous surgery, indication for capsule endoscopy, intestinal transit time, diagnosis, completion rate (percentage of capsules reaching the caecum), diagnostic yield (percentage of results compatible with indication for the exam) and adverse events were collected. RESULTS: From January 2009 to May 2019 fifty-seven patients were included (39 male, mean age 66±15 years). The most common indications for the exam were "overt" (50.9%) and "occult" (35.1%) small bowel bleeding. Previous Billroth II gastrectomy and Roux-en-Y gastric bypass were present in 52.6% and 17.5% of patients respectively. The capsule was swallowed in 34 patients and placed endoscopically in 23 patients. No significant differences were observed between the oral ingestion and endoscopic delivery groups in terms of completion rate (82.4% vs. 78.3%; p=0.742), diagnostic yield (41.2% vs. 52.2%; p=0.432) or small bowel transit time (301 vs. 377min, p=0.118). No capsule retention occurred. Only one severe adverse event (anastomotic perforation) was observed in the endoscopic delivery group. CONCLUSIONS: In our case series, there were no significant differences between oral ingestion and endoscopic delivery in terms of completion rate, diagnostic yield or safety. Being less invasive, oral ingestion of the capsule should be the first-choice method in patients with previous gastrointestinal surgery.


Assuntos
Endoscopia por Cápsula , Procedimentos Cirúrgicos do Sistema Digestório , Enteropatias/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Idoso , Endoscopia por Cápsula/efeitos adversos , Endoscopia por Cápsula/estatística & dados numéricos , Ceco/diagnóstico por imagem , Deglutição , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Endoscopia Gastrointestinal/efeitos adversos , Feminino , Gastrectomia , Derivação Gástrica , Hemorragia Gastrointestinal/etiologia , Trânsito Gastrointestinal , Humanos , Masculino , Estudos Retrospectivos , Espanha
16.
Gastroenterol. latinoam ; 32(1): 14-17, 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1352376

RESUMO

Meckel's diverticulum can be present in up to 1.2% of the population. It is usually diagnosed as an imaging finding, but it can present with complications such as digestive bleeding, intestinal obstruction, diverticulitis, ulcers, and perforation, more frequently in childhood or infancy. The diagnosis workup for this condition will depend on their clinical manifestation, the most frequent being gastrointestinal bleeding of obscure origin or small intestinal bleeding. In this context, although capsule endoscopy is the preferred technique, its diagnostic yield for the detection of Meckel's diverticulum is not entirely clear and it has not been compared in a controlled studies with other diagnostic methods. Here we report the diagnosis of a Meckel diverticulum and its intestinal complications by means of capsule endoscopy in a patient with iron deficiency anemia and gastrointestinal bleeding


El divertículo de Meckel puede estar presente en el 1,2% de la población general. Usualmente es diagnosticado como un hallazgo, pero puede presentarse con mayor frecuencia en la niñez o infancia por sus complicaciones como hemorragia digestiva, obstrucción intestinal, diverticulitis, úlceras y perforación. El enfrentamiento diagnóstico de esta condición dependerá de la manifestación clínica, siendo lo más frecuente hemorragia digestiva de origen oscuro o de intestino delgado. En este contexto, si bien la cápsula endoscópica es la técnica de elección, su rendimiento diagnóstico para la detección del divertículo de Meckel no es del todo claro y no ha sido comparado de forma controlada con otras técnicas diagnósticas. En el presente caso se reporta el diagnóstico de un divertículo de Meckel y sus complicaciones intestinales mediante cápsula endoscópica en una paciente con anemia ferropriva y hemorragia digestiva.


Assuntos
Humanos , Feminino , Adolescente , Endoscopia por Cápsula/métodos , Divertículo Ileal/diagnóstico por imagem , Tomografia Computadorizada por Raios X
17.
Cir Cir ; 88(6): 714-720, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33254184

RESUMO

BACKGROUND: The endoscopic video capsule (EVC), a minimally invasive method of study of the gastrointestinal system indicated in occult gastrointestinal bleeding, has as main complication the retention of endoscopic capsule (CR), currently it is managed with direct extraction using double-balloon enteroscopy; however, when it fails due to its location or associated pathologies, the surgical intervention results in the most successful approach. OBJECTIVE: To evaluate clinical characteristics and management of patients with video capsule endoscopy retention. METHOD: From January 2001 to December 2018, a retrospective search was carried out in three centers, of patients with CR diagnosis, clinical variables and approach were evaluated, in addition to a critical review of the literature. RESULTS: 15 patients with a diagnosis of CR (eight 8 women and seven men), average age 65 (range: 45-77). Seven required surgical management, three endoscopic and five medical management. CONCLUSIONS: The CR is a new pathology of low prevalence, the surgical management resulting from a second therapeutic line when the removal of the VCE has not been possible endoscopically, this pathology requires special attention in the patient's medical history and symptoms for diagnosis and management.


ANTECEDENTES: La videocápsula endoscópica (VCE), método mínimamente invasivo de estudio del sistema gastrointestinal indicado en hemorragia digestiva oculta, tiene como principal complicación la retención de la cápsula endoscópica (RCE). Actualmente se maneja con extracción directa empleando enteroscopia de doble balón; sin embargo, cuando falla por su localización o por patologías asociadas, la intervención quirúrgica resulta el método de mayor éxito. OBJETIVO: Evaluar las características clínicas y el manejo de pacientes con RCE. MÉTODO: De enero de 2001 a diciembre de 2018 se realizó un búsqueda retrospectiva, en tres centros, de pacientes con diagnóstico de RCE. Se evaluaron variables clínicas y de manejo, y además se realizó una revisión crítica de la literatura. RESULTADOS: Se hallaron 15 pacientes con diagnóstico de RCE (ocho mujeres y siete hombres), con una edad promedio de 65 años (rango: 45-77). Siete requirieron manejo quirúrgico, tres manejo endoscópico y cinco manejo médico. CONCLUSIONES: La RCE es una patología nueva de baja prevalencia. El manejo quirúrgico resulta ser una segunda línea terapéutica cuando la extracción de la VCE no ha sido posible endoscópicamente. Para su diagnóstico y manejo, esta patología requiere una especial atención a la historia clínica, los antecedentes y los síntomas de los pacientes.


Assuntos
Endoscopia por Cápsula , Pica , Idoso , Feminino , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Estudos Retrospectivos
18.
Rev Gastroenterol Mex (Engl Ed) ; 85(2): 140-144, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31130307

RESUMO

INTRODUCTION: Appearing in the year 2000, capsule endoscopy revolutionized the study of the small bowel. It is the gold standard for the study of small bowel bleeding and is considered a safe procedure. OBJECTIVE: The aim of the present study was to identify the indications for, diagnostic yield, and safety of capsule endoscopy in Mexican patients. MATERIALS AND METHODS: A descriptive study was conducted on the first 500 small bowel capsule endoscopies performed at a tertiary care hospital center in Mexico City. Sex, age, type of video camera employed, bowel transit time, referral diagnosis, and capsule endoscopy findings and complications were registered. RESULTS: Mean patient age was 55years (±17.63) and 57.9% of the cases were women. Complete visualization of the small bowel was achieved in 420 capsule endoscopies (84%). Mean bowel transit time was 272.25minutes (±114.86). The most common indications for the procedure were small bowel bleeding (65.2%), search for neoplasia (14.4%), and Crohn's disease (10.2%). The presence of ulcers was the most common finding in small bowel bleeding (24.8%), followed by angioectasias (18.9%). Capsule retention was the only complication and it presented in 11 patients (2.2%). CONCLUSIONS: Capsule endoscopy is a safe and efficacious method for studying the small bowel. The results obtained in Mexican patients were similar to those described in the international literature. The present case series is the largest reported in a Mexican population.


Assuntos
Endoscopia por Cápsula , Enteropatias/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos Transversais , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Segurança do Paciente , Estudos Retrospectivos , Centros de Atenção Terciária , Adulto Jovem
19.
Rev Gastroenterol Mex (Engl Ed) ; 85(3): 240-245, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31582187

RESUMO

INTRODUCTION AND AIMS: Capsule endoscopy has revolutionized the study of small bowel disorders. Its diagnostic yield, reasons for referral, and frequency of significant endoscopic findings at our institution are unknown. The aims of our study were to describe the reasons for referral, the frequency of significant endoscopic findings, and the diagnostic yield of capsule endoscopy in patients that underwent the procedure for the study of small bowel disorders. MATERIAL AND METHODS: A retrospective study was conducted that included all patients that underwent capsule endoscopy for small bowel disorder evaluation at our institution. The diagnostic yield for significant endoscopic findings, the frequency of significant endoscopic findings, and the reasons for referral for capsule endoscopy were determined. RESULTS: A total of 134 patients were included in the study and 143 capsule endoscopies were performed. Women made up 48.5% of the sample and the mean patient age was 63 years (18.7 standard deviation). The main reasons for referral were suspicion of overt small bowel bleeding (55.9%) and suspicion of occult small bowel bleeding (28.6%). The overall diagnostic yield was 66.4%. The most common significant findings were small bowel angioectasias (52.6%) and small bowel ulcers (38.9%). There were two adverse events (1.3%): one capsule retention that required enteroscopic removal and one asymptomatic bronchoaspiration of the capsule that resolved spontaneously. CONCLUSIONS: The frequency of significant endoscopic findings with capsule endoscopy at our institution was different from that reported in other Mexican studies, but the reasons for referral and the diagnostic yield were similar.


Assuntos
Endoscopia por Cápsula , Enteropatias/patologia , Intestino Delgado , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Prática Privada , Encaminhamento e Consulta , Estudos Retrospectivos
20.
ABCD (São Paulo, Impr.) ; 33(2): e1532, 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1130538

RESUMO

ABSTRACT Background: The small-bowel is the most difficult segment to be visualized by traditional endoscopic methods. The need for its exploration led to the development of capsule endoscopy. The percentage of the complete examination varies and still remains uncertain the factors that influence the complete and incomplete examination. Aim: Evaluate the factors that interfere with the completeness of the endoscopic evaluation by the capsule. Methods: A prospective study in which were included 939 patients divided into two groups: complete group (CG) and incomplete group (IG). The studied variables that could interfere were: age, gender, comorbidities, diagnosis of Crohn's disease, previous abdominal surgery, inadequate preparation to compare the groups reached and did not reach the cecum. Results: Of the 939 patients included 879 (93.3%) reached the cecum (CG) and 63 (6.7%) IG no. The IG was composed of 29 (46.0%) men and 34 (54.0%) women with a mean age of 49.7 years; comorbidities this group accounted for 46% of which 15.9% was Crohn's disease, previous abdominal surgery 22.2% and 17.5% inadequate preparation. Conclusion: Factors associated with complete or incomplete outcome of the examination with capsule endoscopy were: associated comorbidities, Crohn's disease, previous abdominal surgery and inadequate preparation.


RESUMO Racional: O intestino delgado é segmento de maior dificuldade na visualização pelos métodos endoscópicos tradicionais. A necessidade de explorá-lo levou ao desenvolvimento da cápsula endoscópica. A porcentagem do exame completo por ela varia e falta identificar fatores que influenciam o exame completo e incompleto. Objetivo: Avaliar os fatores que interfiram na completude do estudo endoscópico pela cápsula. Método: Estudo prospectivo onde foram incluídos 939 pacientes divididos em dois grupos: grupo completo (GC) e grupo incompleto (GI). As variáveis analisadas que pudessem interferir foram: idade, gênero, comorbidades associadas, diagnóstico de doença de Crohn, operações abdominais prévias, preparo inadequado para comparar os grupos que atingiram e não atingiram o ceco. Resultados: Dos 939 pacientes incluídos 879 (93,3%) atingiram o ceco (GC) e 63 (6,7%) GI não. O GI era composto por 29 (46,0%) homens e 34 (54,0%) mulheres com idade média de 49,7 anos; as comorbidades deste grupo corresponderam a 46%, das quais 15,9% era doença de Crohn, 22,2% operação abdominal prévia e 17,5% preparo inadequado. Conclusão: Os fatores associados ao desfecho completo ou incompleto do exame com a cápsula endoscópica foram: comorbidades associadas, doença de Crohn, operação abdominal prévia e preparo inadequado.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Endoscopia por Cápsula , Intestino Delgado/diagnóstico por imagem , Procedimentos Cirúrgicos do Sistema Digestório , Doença de Crohn , Comorbidade , Estudos Prospectivos , Resultado do Tratamento
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