Role of capsule endoscopy in small bowel management

Research output: ThesisDoctoral Thesis (compilation)

Standard

Role of capsule endoscopy in small bowel management. / Nemeth, Artur.

Lund : Lund University, Faculty of Medicine, 2019. 70 p.

Research output: ThesisDoctoral Thesis (compilation)

Harvard

Nemeth, A 2019, 'Role of capsule endoscopy in small bowel management', Doctor, Department of Clinical Sciences, Malmö, Lund.

APA

Nemeth, A. (2019). Role of capsule endoscopy in small bowel management. Lund: Lund University, Faculty of Medicine.

CBE

Nemeth A. 2019. Role of capsule endoscopy in small bowel management. Lund: Lund University, Faculty of Medicine. 70 p.

MLA

Nemeth, Artur Role of capsule endoscopy in small bowel management Lund: Lund University, Faculty of Medicine. 2019.

Vancouver

Nemeth A. Role of capsule endoscopy in small bowel management. Lund: Lund University, Faculty of Medicine, 2019. 70 p. ('Lund University, Faculty of Medicine Doctoral Dissertation Series; 26).

Author

Nemeth, Artur. / Role of capsule endoscopy in small bowel management. Lund : Lund University, Faculty of Medicine, 2019. 70 p.

RIS

TY - THES

T1 - Role of capsule endoscopy in small bowel management

AU - Nemeth, Artur

N1 - 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

PY - 2019

Y1 - 2019

N2 - 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 thevalue 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 usinga 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 meaningfulresults 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 ofpediatric 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.

AB - 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 thevalue 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 usinga 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 meaningfulresults 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 ofpediatric 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.

KW - Capsule endoscopy

KW - Crohn's disease,

KW - Patency capsule

KW - small bowel

KW - Capsule retention

M3 - Doctoral Thesis (compilation)

SN - 978-91-7619-755-4

VL - 2019:26

T3 - 'Lund University, Faculty of Medicine Doctoral Dissertation Series

PB - Lund University, Faculty of Medicine

CY - Lund

ER -