The Role of PillCam Endoscopy in Crohn's Disease: the European Experience
Section snippets
Comparison with other tests
Several studies comparing WCE with standard methods in the diagnostic yield of CD have been published. A comparative study performed in dogs showed that push enteroscopy was superior to WCE in detecting lesions within the reach of the push enteroscope. WCE, however, did not miss many findings observed by push enteroscopy and furthermore provided images from the large portion of the small intestine that could not be reached by push enteroscopy [4]. In summary, five comparisons of WCE and push
Strictures and capsule retention
The main concern in the use of WCE in CD who have CD is the fear that the capsule might remain within the small intestine by fluctuating freely before or by becoming impacted within a small intestinal stricture. This may cause painless capsule retention or small bowel obstruction requiring emergency surgery. Some of these retained capsules can be retrieved endoscopically; some need surgery to be taken out. The International Conference on Capsule Endoscopy working group defined capsule retention
How to avoid capsule retention? The role of the patency capsule
Early clinical protocols excluded any patients with a hint of previous subacute obstruction or symptoms suggestive of CD [1], [26], [27]. In fact, a few patients who had CD inadvertently were included in these early studies, as CD may rarely have its first manifestation as GI bleeding. The symptom presentation in these patients is otherwise often subtle, and other investigations are sometimes inconclusive. Twenty patients with capsule retention have been reported; 17 patients had normal
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