Endoscopy 2006; 38(1): 31-35
DOI: 10.1055/s-2005-921189
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

The Accuracy of PillCam ESO Capsule Endoscopy Versus Conventional Upper Endoscopy for the Diagnosis of Esophageal Varices: A Prospective Three-Center Pilot Study

G.  M.  Eisen1 , R.  Eliakim2 , A.  Zaman1 , J.  Schwartz1 , D.  Faigel1 , E.  Rondonotti3 , F. Villa3 , E.  Weizman2 , K.  Yassin2 , R.  deFranchis3
  • 1Department of Medicine, Oregon Health and Science University, Portland, Oregon, USA
  • 2Department of Gastroenterology, Rambam Medical Center, Haifa, Israel
  • 3Gastroenterology and Gastrointestinal Endoscopy Service, Department of Internal Medicine, University of Milan, Milan, Italy
Further Information

Publication History

Submitted 13 October 2005

Accepted after revision 12 November 2005

Publication Date:
23 January 2006 (online)

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Background and Study Aims: Variceal bleeding is a major complication of cirrhosis, and is associated with a 20 % mortality at 6 weeks. Current international guidelines recommend that patients with cirrhosis are screened by conventional upper endoscopy (esophagogastroduodenoscopy, EGD) in order to detect esophageal varices. The recently developed PillCam ESO esophageal capsule endoscope has been shown to be an accurate diagnostic tool in the investigation of patients with gastroesophageal reflux and Barrett’s esophagus. We compared the PillCam ESO capsule endoscope with EGD for the detection of esophagogastric varices and portal hypertensive gastropathy in patients with cirrhosis.
Patients and Methods: A pilot trial was conducted at three sites. Patients with cirrhosis who were undergoing clinically indicated EGD for screening or surveillance for esophageal varices underwent a PillCam ESO study followed by an EGD within 48 hours. Capsule videos were assessed by an investigator who was blinded to the patient’s medical history and EGD findings.
Results: A total of 23 of the 32 enrolled patients were found to have esophageal varices at both EGD and PillCam ESO endoscopy. In one patient PillCam ESO detected small varices that were not seen at EGD. The overall concordance between PillCam ESO and EGD was 96.9 % for the diagnosis of esophageal varices and 90.6 % for the diagnosis of portal hypertensive gastropathy. There were no adverse events related to PillCam ESO endoscopy.
Conclusions: In a high-prevalence population, PillCam ESO may represent an accurate noninvasive alternative to EGD for the detection of esophageal varices and portal hypertensive gastropathy. A large-scale trial is underway to validate and expand these findings.