| ObjectiveTo analyze the detection and diagnosis of capsule endoscopy in small intestinal diseases,explore the correlation between its pathological results and the clinical characteristics of the subject,and explore the relevant factors that affect the transit time of capsule endoscopy in the gastrointestinal tract and the incomplete small intestinal examination,so as to provide a reference for improving the completion rate of clinical capsule endoscopy in the whole small intestine examination.MethodsFrom 2013 to 2022,we collected the capsule endoscopy report results,treatment type,gender,age,main symptoms,smoking history,drinking history,previous abdominal surgery history,diabetes history,serum potassium indicators,albumin indicators,gastroscopy and colonoscopy report results,gastrointestinal biopsy pathological results,and gastrointestinal transit time of capsule endoscopy from the people who received capsule endoscopy in the Affiliated Hospital of Youjiang Medical College for Nationalities.To analyze the success rate of capsule endoscopy,the completion rate of whole small bowel examination,the detection and diagnosis of lesions in small intestinal diseases using capsule endoscopy,the correlation between the results of capsule endoscopy and the clinical characteristics of the subject,and the factors that affect the transit time of capsule endoscopy in the gastrointestinal tract and the incomplete small bowel examination.Results(1)A total of 391 patients were included in this study,including 220outpatients(56.3%)and 171 inpatients(43.7%);208 males(53.20%)and 183females(46.80%);The age ranged from 7 to 82 years,with an average age of(43.98 ± 15.476)years;The main symptoms were obscure gastrointestinal bleeding in 51 cases(13.04%),abdominal pain and abdominal distension in 258cases(65.98%),stool changes in 38 cases(9.72%),and other symptoms in 44cases(11.26%)(anorexia in 4 cases,fatigue in 1 case,elevated CA125 in 1 case,physical examination in 26 cases,reexamination after the treatment of the original diagnosis of Crohn disease in 8 cases,hiccup in 1 case,and emaciation in 3 cases).(2)Among 373 cases of successful small bowel examination,267 cases were found to have small bowel lesions,with a total detection rate of 71.58%(267/373).Among 39 cases of Crohn disease detected by capsule endoscopy,8 cases were reexamined after the treatment of the original diagnosis of Crohn disease.Among 31 newly detected cases of Crohn disease,10 cases of Crohn disease were excluded through follow-up,colonoscopy and enteroscopy,and 21 cases were diagnosed as Crohn disease.The diagnostic rate of Crohn disease was 74.35%(29/39).(3)The detection rate of small intestinal lesions by capsule endoscopy in different age groups: The detection rate of small intestinal lesions in the underage group was(27/29)93.10%,the youth group was(91/128)71.09%,the middle-aged group was(129/190)67.89%,and the elderly group was(20/26)76.92%.Through analysis,it was found that the detection rate of the four groups(P<0.05)was statistically significant,with the detection rate of the underage group being higher than that of the young and middle-aged groups(x~2= 6.135,7.802,p<0.05),but there was no statistically significant difference in detection rate compared to the elderly group(x~2= 2.888,p>0.05).There was no statistically significant difference in the detection rate of small intestinal lesions between the youth group,the middle-aged group,and the elderly group(x~2= 0.367,0.365,p>0.05).There is no statistically significant difference in the detection rate of small intestinal lesions between the middle-aged and elderly groups(x~2= 0.871,p>0.05).(4)The detection rate of small intestinal lesions by capsule endoscopy was 73.10%(144/197)in males and 69.89%(123/176)in females.There was no statistically significant difference between the two(P>0.05).(5)Detection of small intestinal lesions by capsule endoscopy with different symptoms: The detection rate of small intestinal lesions with obscure gastrointestinal bleeding(87.80%)was significantly higher than that with abdominal pain and abdominal distension(71.20%),stool changes(73.68%),and other symptoms(56.82%)(P<0.05).(6)No retention occurred in 391 cases of capsule endoscopy.The success rate of capsule endoscopy was 100%,with 373 cases completing small bowel examination and 18 cases not completing small bowel examination.The completion rate of whole small bowel examination was 95.40%(373 /391).(7)There was no significant difference in sexes,ages,smoking history,alcohol drinking history,main symptoms,abdominal surgery history,diabetes history,serum potassium and albumin(p>0.05),and there was significant difference in gastric transit time between patients with bile reflux and those without bile reflux,with statistical significance(p<0.05).The gastric transit time of patients with bile reflux was longer than those without bile reflux.(8)There was no significant difference(p>0.05)in small bowel transit time among alcohol drinking history,abdominal surgery history,diabetes history,serum potassium and albumin.There were significant differences in small bowel transit time among sexes,ages,smoking history,and main symptoms(p<0.05).The small bowel transit time of women was longer than that of men;The small bowel transit time at different age stages was significantly longer for those aged ≥ 65 years than for those at other age stages.(9)The univariate analysis results of 18 cases of incomplete small bowel examination showed that the type of visit,obscure gastrointestinal bleeding,serum potassium,albumin,abdominal surgery history,gastric transit time<30 min,gastric transit time ≥120 min,and the types of active bleeding,vascular malformations,and erosion/ulcer detected in the small bowel were all P<0.05,with a statistically significant difference,indicating an impact on incomplete small bowel examination.Statistical significant factors were included in a multivariate binary logistic regression analysis,and the results showed that active bleeding,erosion/ulcers,and gastric transit time ≥ 120 min were positively correlated with incomplete small bowel examination.Conclusion(1)Capsule endoscopy is an effective examination method for patients with obscure gastrointestinal bleeding,abdominal pain,abdominal distention,and stool changes.It can provide guidance for further clarification of the diagnosis through enteroscopy and colonoscopy.(2)Capsule endoscopy has certain application value in the diagnosis,condition monitoring and therapeutic efficacy evaluation of Crohn disease.(3)The detection rate of small intestinal lesions under capsule endoscopy is related to age and main symptoms,but not to gender.(4)The small bowel transit time of capsule endoscopy is influenced by gender,age,smoking history,and main symptoms.The small bowel transit time is significantly prolonged in patients aged ≥ 65 years.(5)Active bleeding,erosion,ulcer,and gastric transit time ≥ 120 min among the types of small bowel lesions detected are positively correlated with incomplete small bowel examination by capsule endoscopy. |
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