Role of capsule endoscopy in small bowel management

Research output: ThesisDoctoral Thesis (compilation)

Abstract

The small bowel is difficult to reach and to examine endoscopically. Video capsule endoscopy (VCE) using a wireless imaging technology was introduced 2000. VCE is an ingestible capsule camera that takes photographs during its passage throughout the gastrointestinal tract. The diagnosis of small bowel Crohn's disease is among the prime indications for VCE, as one third of patients with Crohn's disease have only small bowel involvement.
The aim of this thesis is to increase the knowledge and critically evaluate the use of VCE and its capability to diagnose small bowel Crohn's disease and to explore the most concerning complication of VCE - capsule retention. Specific aims were to explore the risk of capsule retention, to evaluate the clinical impact and the
value of the patency capsule test on the risk of capsule retention, to describe the clinical impact of VCE in patients with established Crohn's disease and to examine the impact and safety of VCE performed in children.
The usefulness and risk of VCE was evaluated in different clinical situations. The studies were performed using three different models of small bowel capsule endoscopes. Patency capsule examinations were performed using
a first or a second generation patency capsule.
The studies demonstrate that capsule retention is a rare complication of VCE. Moreover, a majority of patients with capsule retention can be safely and effectively managed with endoscopic intervention instead of surgery.
The results suggest that routine nonselective administration of the patency capsule before VCE in patients with established Crohn's disease is not likely to reduce the risk of video capsule retention. VCE provides meaningful
results leading to therapeutic changes in more than 50% of patients with established Crohn's disease. VCE is a safe method and often leads to a definitive diagnosis and has a significant impact on the clinical management of
pediatric patients with Crohn's disease.
Taken together, VCE has a high capability to diagnose small bowel Crohn's disease and is a very safe method to investigate the small bowel mucosa. The few cases with capsule retention can be mostly managed with endoscopic intervention.

Details

Authors
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Medical and Health Sciences

Keywords

  • Capsule endoscopy, Crohn's disease, Patency capsule, small bowel, Capsule retention
Original languageEnglish
QualificationDoctor
Awarding Institution
Supervisors/Assistant supervisor
Award date2019 Mar 29
Place of PublicationLund
Publisher
  • Lund University, Faculty of Medicine
Print ISBNs978-91-7619-755-4
Publication statusPublished - 2019
Publication categoryResearch

Bibliographic note

Defence details Date: 2019-03-29 Time: 09:00 Place: Lilla aulan, Jan Waldenströms gata 5, Skånes Universitetssjukhus i Malmö External reviewer(s) Name: Strid, Hans Title: docent Affiliation: Göteborg

Total downloads

No data available

Related research output

Artur Nemeth, Wurm Johansson, G., Nielsen, J., Henrik Thorlacius & Toth, E., 2017 Aug 1, In : United European Gastroenterology Journal. 5, 5, p. 677-686 10 p.

Research output: Contribution to journalArticle

Kopylov, U., Artur Nemeth, Koulaouzidis, A., Makins, R., Wild, G., Afif, W., Bitton, A., Wurm Johansson, G., Bessissow, T., Eliakim, R., Toth, E. & Seidman, E. G., 2015, In : Inflammatory Bowel Diseases. 21, 1, p. 93-100

Research output: Contribution to journalArticle

View all (4)