Diagnositic value of capsule endoscopy for small intestinal diseases and the influence of prokinetic agents on its operation
10.3969/j.issn.1672-8467.2025.06.010
- VernacularTitle:胶囊内镜对小肠疾病的诊断价值及促动力药物对其运行的影响
- Author:
Hai-yan WANG
1
;
Miao JIANG
1
;
Shao-ren ZHANG
1
Author Information
1. 复旦大学附属金山医院消化内科 上海 201508
- Publication Type:Journal Article
- Keywords:
capsule endoscopy(CE);
prokinetic agents;
small bowel enteroscopy-CT(SBE-CT);
double balloon enteroscopy(DBE);
small intestine disease;
diagnosis
- From:
Fudan University Journal of Medical Sciences
2025;52(6):854-861
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the characteristics of capsule endoscopy(CE)in small intestinal diseases and the effect of prokinetic agents on CE,and to explore the diagnostic value of CE in small intestinal diseases.Methods Clinical data were collected from 332 patients who underwent CE in Jinshan Hospital,Fudan University between May 2020 and Mar 2024,and the etiology and endoscopic characteristics of small intestinal diseases were analyzed.Patients were categorized based on the administration of metoclopramide into the non-use group(Group A)and use group(Group B).Group A was further subdivided based on whether the CE reached the cecum,forming the non-reach group(Group c)and the reach cecum group(Group d).Then we compared the capsule gastric transit time,small intestine transit time,completion rate of the entire small intestine examination,and lesion detection rate across these groups.Additionally,the detection rates of CE were compared with those of colonoscopy,small bowel enteroscopy-CT(SBE-CT),and double-balloon enteroscopy(DBE).Results The most prevalent small intestinal lesions identified were erosions and ulcers,with Crohn's disease(CD)being the primary cause of ulcers,endoscopic ulcers exhibited atypical and diverse presentations,including aphthous and irregular ulcers.In comparison to Group A,Group B demonstrated a shorter small bowel transit time(P<0.05)and a higher lesion detection rate(P<0.05),while no significant difference was observed in the completion rate of the entire small bowel examination.Gastric emptying time and small intestinal transit time were prolonged in Group c compared with Group d(P<0.05).There was no significant difference in the diagnostic rate of terminal ileum lesions between CE and colonoscopy,while the diagnostic rate of CE was higher in patients with terminal ileum lesions under colonoscopy(P<0.05).The diagnostic rate of CE was higher than that of SBE-CT(P<0.05),and the detection rate of CE and DBE was comparable.Conclusion The morphology of small intestinal ulcers varies,and the endoscopic findings are not specific.Metoclopramide administered in real time after capsule ingestion can shorten the intestinal transit time and improve the diagnostic rate of CE.Positive lesions found during colonoscopy should be further evaluated with CE examination,the diagnostic accuracy of CE is higher than that of SBE-CT,CE and DBE have the same diagnostic value for small intestinal diseases.
