DESCRIPTIVE ANALYSIS OF 159 CONSECUTIVE CAPSULE ENDOSCOPIES AT A REFERRAL CENTER IN BUDAPEST

Aims:

To evaluate characteristics of patients visiting a referral center for capsule endoscopy (CE) during 2014 – 2017.

Methods:

MiroCam was used for diagnosis of gastrointestinal bleeding and evaluated by two physicians. Including criteria was negative bleeding in endoscopy examination within 3 months. Detailed questionnaire was applied.

Results:

159 CE were performed for 156 patients (73 males, 83 females). Age-range was 17 – 86 (mean: 60). BMI-varied between 16.6 and 49 (mean: 27). H. pylori was tested in 46% of patients and amongst 19% positive. Transfusion of 426 units was reported in 58% of cases. Six cases had bleeding disorder. Regular NSAID users were 18%. Anticoagulant drugs were taken by 52 (32%) cases. Mean duration of CE was 543 minutes (ranged: 138 – 720). Mean passage time in stomach and small intestine (SI) was 38 and 270 minutes. Gastric lesions included 17 active bleeding, 2 ulcers, 6 telangiectasias. CE of small intestine showed 65% hyperemia, 82% doted erosions, 18% spotted erosions, 18% ulcers, 28% telangiectasias, 33% angiodysplasias, 18% active bleedings, 30% lymphangiectasis, 31% polypoid lesions, and 4% tumor-like lesions. Cecal images showed 4 active bleedings, 2 ulcers, 12 telangiectasias and angiodysplasias. Capsule regurgitation from stomach to duodenum and from coecum to ileum was noted in 15 (9%) and 3 (2%). Concordant gastric vascular lesions coexisted in 50% with SI lesions, whereas all vascular lesions in colon coexisted with SI lesions. NSAID use was associated with spotted erosion and ulcer in SI (p = 0.028). H. pylori, smoking, alcohol, anticoagulant use and BMI were not associated with SI bleeding. In follow-up data (31%), death incidence was higher among those with bleeding or ulcer in SI detected by CE (p = 0.003).

Conclusions:

Vascular lesions were the most common observed abnormalities of small intestine in our series. High proportion of mortality among ulcerative lesions in CE highlights the importance of post-capsule follow-up.