Zusammenfassung
Im nachfolgenden wird das Update 2004 des Positionspapiers Kapsel-Endoskopie der Sektion Endoskopie der Deutschen Gesellschaft für Verdauungs- und Stoffwechselerkankungen (Originalzitat: Zeitschrift für Gastroenterologie 2004; 42: 247-259) abgedruckt. Die Kapselendoskopie (KE) ist eine nicht-invasive Methode der Dünndarmdiagnostik. Auf der Grundlage einer aktuellen Literaturanalyse und der belegten Evidenz werden Empfehlungen für ihren Einsatz in der Praxis gegeben. Bei Patienten mit ungeklärter/okkulter gastrointestinaler Blutung ist die KE indiziert, wenn obere und untere gastrointestinale Endoskopie einschließlich Ileoskopie keine Klärung erbringen. Die KE kann hilfreich sein bei der Diagnostik des Morbus Crohn, der indeterminierten Colitis und bei Polypse-Syndromen. Andere Indikationen wie die nichttropische Sprue, ungeklärte Diarhö und abdominelle Schmerzen sind Gegenstand klinisch kontrollierter Studien.
Abstract
The following update paper of the position statement of the Endoscopy Section of the German Society of Gastroenterology and Metabolic diseases (DGVS) on the clinical use of capsule endoscopy is a reprint of the original publication (Zeitschrift für Gastroenterologie 2004; 42: 247-259). Capsule endoscopy (CE) is a non-invasive diagnostic procedure to diagnose abnormalities of the small bowel. The current literature is reviewed and recommendations for clinical applications of CE are given which are based on available published evidence. In patients with obscure and occult gastrointestinal bleeding CE is indicated after non-conclusive upper and lower GI endoscopy including ileoscopy. CE may be useful in the diagnosis of suspected Crohn's disease, indeterminate colitis and polyposis syndromes. Controlled clinical studies are needed for other indications such as celiac disease, unexplained diarrhea and abdominal pain.
Schlüsselwörter
Dünndarmdiagnostik - gastrointestinale Blutung - Morbus Crohn
Key words
Small bowel diagnostics - gastrointestinal bleeding - Crohn's disease
Literatur
1
Iddan G, Meron G, Glukhovsky A. et al .
Wireless capsule endoscopy.
Nature.
2000;
405
417
2
Appleyard M, Fireman Z, Glukhovsky A. et al .
A randomized trial comparing wireless capsule endoscopy with push enteroscopy for the detection of small-bowel lesions.
Gastroenterology.
2000;
119
1431-1438
3
Ell C, Remke S, May A. et al .
The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding.
Endoscopy.
2002;
34
685-689
4
Lewis B S, Swain P.
Capsule endoscopy in the evaluation of patients with suspected small intestinal bleeding. Results of a pilto study.
Gastrointest Endosc.
2002;
56
349-353
5
Saurin J C, Delvaux M, Gaudin J L. et al .
Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: Blinded comparison with video push-enteroscopy.
Endoscopy.
2003;
35
576-584
6
Mylonaki M, Fritscher-Ravens A, Swain P.
Wireless capsule endoscopy: a comparison with push enteroscopy in patients with gastroscopy and colonoscopy negative gastrointestinal bleeding.
Gut.
2003;
52
1122-1126
7
Pennazio M, Santucci R, Rondonotti E. et al .
Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: Report of 100 consecutive cases.
Gastroenterology.
2004;
(in press)
8
Van Gossum A, Hittelet A, Schmit A. et al .
A prospective comparative study of push and wireless-capsule enteroscopy in patients with obscure digestive bleeding.
Acta Gastro-Enterologica Belgica.
2003;
66
199-205
9
Hartmann D, Schilling D, Bolz G. et al .
Capsule endoscopy versus Push Enteroscopy in patients with occult gastrointestinal bleeding.
Z Gastroenterol.
2003;
41 (5)
377-382
10
Herrerias J M, Caunedo A, Rodriguez-Tellez M. et al .
Capsule endoscopy in patients with suspected Crohn's disease and negative endoscopy.
Endoscopy.
2003;
35
564-568
11
Eliakim R, Fischer D, Suissa A. et al .
Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn's disease.
Eur J Gastroenterol Hepatol.
2003;
15
363-367
12
Fireman Z, Mahajna E, Broide E. et al .
Diagnosing small bowel Crohn's disease with wireless capsule endoscopy.
Gut.
2003;
52
390-392
13
Costamagna G, Sha S K, Riccioni M E. et al .
A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease.
Gastroenterology.
2002;
123
999-1005
14
Liangpunsakul S, Chadalawada V, Rex D K. et al .
Wireless capsule endoscopy detects small bowel ulcers in patients with normal results from state of the art enteroclysis.
Am J Gastroenterol.
2003;
98
1295-1298
15
Hara A K, Leighton J A, Sharma V K. et al .
Small Bowel: Preliminary comparison of capsule endoscopy with barium study and CT.
Radiology.
2004;
230 (1)
260-265
16
Ang T L, Fock K M, Ng T M. et al .
Clinical utility, safety and toelrability of capsule endoscopy in urban Southeast Asian population.
World J Gastroenterol.
2003;
9
2313-2316
17
Scapa E, Jacob H, Lewkowicz S. et al .
Initial experience of wireless-capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology.
Am J Gastroenterol.
2002;
97
2776-2779
18
Voderholzer W A, Ortner M, Rogalla P. et al .
Diagnostic yield of wireless capsule enteroscopy in comparison with computed tomography enteroclysis.
Endoscopy.
2003;
35
1009-1014
19
Bardan E, Nadler M, Chowers Y. et al .
Capsule endoscopy for the evaluation of patients with chronic abdominal pain.
Endoscopy.
2003;
35
688-689
20
Keuchel M, Hagenmüller F.
Endoskopie des Dünndarms mit der drahtlosen Videokapsel.
Dtsch Ärztebl.
2002;
99
C 2166-C 2171
21
Neu B, Wettschureck E, Röscht T.
Is esophageal capsule endoscopy feasible? Results of a pilot trial.
Endoscopy.
2003;
35
957-961
22
Hahne M, Adamek H E, Schilling D. et al .
Wierless capsule endoscopy in a patient with obscure occult bleeding.
Endoscopy.
2002;
34
588-590
23
Seitz U, Soehendra N.
Solving the problem of video recording gaps in capsule endoscopy of overweight patients.
Endoscopy.
2003;
35
714
24
Mascarenhas-Saraiva M N, da Silva Araujo Lopes L M.
Small-bowel tumors diagnosed by wireless capsule endoscopy: Report of five cases.
Endoscopy.
2003;
35
865-868
25
Madisch A, Schimming W, Kinzel F. et al .
Locally advanced small- bowel adenocarcinoma missed primarily by capsule endoscopy but diagnosed by push enteroscopy.
Endoscopy.
2003;
35
861-864
26
Mylonaki M, MacLean D, Fritscher-Ravens A. et al .
Wireless capsule endoscopic detection of Meckel's diverticulum after non-diagnostic surgery.
Endoscopy.
2002;
34
1018-1020
27
Aabakken L, Blomhoff J P, Jermstad T. et al .
Capsule endoscopy in a patient with Zenker's diverticulum.
Endoscopy.
2003;
35
799
28
Hollerbach S, Keaus K, Willert J. et al .
Endoscopically assistened video capsule endoscopy of the small bowel in patients with functional gastric outlet obstruction.
Endoscopy.
2003;
35
226-229
29
Reddy D N, Sriram P V, Rao G W. et al .
Capsule endoscopy appearances of small-bowel tuberculosis.
Endoscopy.
2003;
35
99
30
Gay G, Delvaux M, Fassler I. et al .
Localization of colonic origin of obscure bleeding with the capsule endoscope: A case report.
Gastrointest Endosc.
2002;
56
758-762
31
Gonzalez-Suarez B, Guarner C, Escudero J R. et al .
Wireless capsule video endoscopy: A new methods for aortoduodenal fissure.
Endoscopy.
2002;
34
938
35
Fisher H, Lo S K, Deleon V P.
Gastrointestinal transit of the wireless endoscopic capsule.
Gastrointest Endosc.
2002;
55
AB 134
36
Van Gossum A, Deviere J.
Wireless endoscope: Methodological features.
Gastrointest Endosc.
2002;
55
AB 135 (abstract)
37
Balba N H, Chutkan R K.
Measurement of gastric and small intestine transit time using the video capsule endoscope.
Gastrointest Endosc.
2002;
55
AB 136 (abstract)
38
Leighton J A, Sharma V K, Yousfi M. et al .
Video capsule endoscopy (VCE): New information and limitations defined.
Gastrointest Endosc.
2002;
55
AB 134 (abstract)
39
de Franchis R, Rondonotti E, Abbiati C. et al .
The technical performance of capsule enteroscopy does not depend on indication and intestinal preparation.
Endoscopy.
2002;
34 (Suppl 2)
A 88 (abstract)
40
Fireman Z, Fich L, Mahajna E. et al .
Effect of colon preparation on gastric and small bowel transit time of capsule endoscopy.
Gut.
2002;
51 (Suppl 3)
A 89 (abstract)
Prof. Dr. Thomas Rösch
II. Medizinische Klinik der TU München
Klinikum rechts der Isar
Ismaningerstr. 22
81675 München
Telefon: 0 89/41 40-22 63
Fax: 0 89/41 40-48 72
eMail: Thomas.Roesch@lrz.tum.de