The Diagnostic Value Of OMOM Capsule Endoscopy In The Small Intestinal Disease

Objectives:To investigate the diagnostic value and safety of OMOM capsule endoscopy (CE) in the small intestinal disease.Methods:A retrospective analysis of clinical data of208patients who underwent CE during January2011to January2014in the XiangYa hospital because of digestive symptoms. All the patients were performed gastroscopy and colonoscopy, but had no positive fingings to explain clinical symptoms. The subjects were telephone interviewed in order to understand their diagnostic accuracy and disease prognosis. For those who performed gastrointestinal barium meal or abdominal CT or double-balloon enteroscopy (DBE), we compared the diagnosis of these methods with capsule endoscopy.Results:1、among the208patients,203patients finished the tests successfully.The ratio of successful examination was97.61%(203/208). Reasons for applying CE test:There were significant differences in the patients with obscure gastrointestinal bleeding(OGIB)between elderly group and non-elderly group(64.06%vs34.72%).Meanwhile, there were significant differences in the patients with abdominal pain between elderly group and non-elderly group(56.25%vs31.25%).2、 The total detective rate of CE was66.01%(134/203), the first four positive findings were ulcer, mucosal inflammation,vascular malformation, occupying lesions. The total diagnostic rate of CE was35.96%(73/203),the first four etiology were Crohn’s disease,vascular malformation, small intestinal tumor, parasitic disease.3、 The outcomes of CE:①Outcomes of OGIB group:the detective rate was80.68%(71/88), positive findings mainly were vascular malformation, occupying lesions, ulcer, mucosal inflammation. The diagnostic rate was52.27%(46/88),the mainly etiology were vascular malformation, small intestinal tumor, Crohn’s disease.②Outcomes of abdominal pain group:the detective rate was55.00%(55/100), positive findings mainly were ulcer, mucosal inflammation, vascular malformation, diverticulum. The diagnostic rate was23.00%(23/100),the mainly etiology were Crohn’s disease, parasitic disease, intestinal diverticula.③Outcomes of diarrhea group:the detective rate was61.54%(8/13),positive findings mainly were mucosal inflammation and ulcer.The diagnostic rate was30.77%(4/13),the etiology were Crohn’s disease and Eosinophilic enteritis.4、The comparison of diagnostic rate of capsule endoscopy with gastrointestinal barium meal and abdominal CT and DBE:①The diagnostic rate of gastrointestinal barium meal was8.04%(9/112),and CE was36.61%(41/112), P<0.05;Comparing with CE,the diagnostic rate of gastrointestinal barium meal combined with CE was38.39%(43/112),P<0.05.②The diagnostic rate of abdominal CT was16.67%(14/84), and CE was29.76%(25/84), P<0.05;Comparing with CE,the diagnostic rate of abdominal CT combined with CE was32.14%(27/84),P<0.05.③he diagnostic rate of DBE was53.85%(7/13),and CE was53.85%(7/13),P>0.05;Comparing with CE,the diagnostic rate of DBE combined with CE was69.23%(9/13),P>0.05.5、The coincidence rate of endoscope diagnosis and pathological diagnosis was66.67%(14/21),the compliance rate of small intestinal stromal tumors was70.00%(7/10).6、The complete small-bowel examination rate was66.70%(136/203).The transit time of gastric more than45min and small-bowel Crohn’s disease were the risk factors of incomplete small bowel examination.7、The tolerance and complications of CE:Capsule retention occurred in3patients, the rate of which was1.47%(3/203).Only one patient eventually developed acute intestinal obstruction. Other patients were well tolerated. Conclusions:1、CE is a reliable and effective examination of small intestinal diseases, the detective rate and diagnostic rate are high. the first four etiology of small-bowel disease were Crohn’s disease, vascular malformation, small intestinal tumor and parasitic disease.2、The detective rate and diagnostic rate of OGIB group were higher than abdominal pain group, The main etiological diagnosis of OGIB group were followed by vascular malformations, small intestinal tumors, Crohn’s disease and intestinal bleeding erosion.3、The transit time of gastric more than45min and small-bowel Crohn’s disease were the risk factors of incomplete small bowel examination.4、CE is superior to gastrointestinal barium meal and abdominal CT in diagnostic rate in small intestinal diseases, the allied examination can improve diagnostic rate. In this study, the diagnostic rates of CE and DBE were equivalent to each other.5、Capsule Endoscopy is relatively safe. Patients were well tolerated and the incidence rate of complications was low.