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Evaluation of Small-Bowel Patency in Crohn’s Disease: Prospective Study with a Patency Capsule and Computed Tomography

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Resumo:Background and Purpose: Patency capsule (PC) examination is usually performed - previously to capsule endoscopy - to evaluate small-bowel patency in patients with established Crohn’s disease (CD). The reported PC retention rate is significantly higher than expected. Our aims were to assess small-bowel patency, to determine the precise location of the retained PC in patients with CD, and to determine the false positive rate of evaluation with a radiofrequency identification tag (RFIT) scanner. Methods: This is a prospective single-center study including CD patients with clinical indication for small-bowel capsule endoscopy. PillCam® PC examination was performed on all patients to assess smallbowel patency. On all patients with a positive identification of the PC using an RFIT scanner, 30 h after ingestion, an abdominal CT was performed in order to identify its precise location. Results: Fifty-four patients were included. The PC retention rate, according to evaluation with the RFIT scanner, was 20% (in 11 patients) 30 h after ingestion. These patients were then submitted to abdominal CT, which revealed that there was small-bowel retention in 5 cases (9%). Higher CRP levels, penetrating disease, and a history of abdominal surgery were associated with an increased risk of PC retention (p = 0.007, p = 0.011, and p = 0.033, respectively). On multivariate analysis, there was an independent association between small-bowel PC retention and CRP levels > 5 mg/dL (OR = 15.5; p = 0.03). Discussion: The small-bowel PC retention rate (9%) was considerably lower than those found in previous reports. Our results show that, with this protocol, the false-positive cases of RFIT scans or plain abdominal Xrays may be avoided. This may contribute to more extensive application of capsule endoscopy without the risk of smallbowel retention.
Autores principais:Silva,Marco
Outros Autores:Cardoso,Hélder; Cunha,Rui; Peixoto,Armando; Gaspar,Rui; Gomes,Sara; Santos,Ana Luísa; Lopes,Susana; Macedo,Guilherme
Assunto:Inflammatory bowel disease Diagnosis and imaging Small-bowel endoscopy Capsule endoscopy Gastrointestinal radiology
Ano:2019
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:inglês
Origem:SciELO Portugal
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author Silva,Marco
author2 Cardoso,Hélder
Cunha,Rui
Peixoto,Armando
Gaspar,Rui
Gomes,Sara
Santos,Ana Luísa
Lopes,Susana
Macedo,Guilherme
author2_role author
author
author
author
author
author
author
author
author_facet Silva,Marco
Cardoso,Hélder
Cunha,Rui
Peixoto,Armando
Gaspar,Rui
Gomes,Sara
Santos,Ana Luísa
Lopes,Susana
Macedo,Guilherme
author_role author
country_str PT
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datacite.creators.creator.creatorName.fl_str_mv Silva,Marco
Cardoso,Hélder
Cunha,Rui
Peixoto,Armando
Gaspar,Rui
Gomes,Sara
Santos,Ana Luísa
Lopes,Susana
Macedo,Guilherme
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Inflammatory bowel disease
Diagnosis and imaging
Small-bowel endoscopy
Capsule endoscopy
Gastrointestinal radiology
datacite.titles.title.fl_str_mv Evaluation of Small-Bowel Patency in Crohn’s Disease: Prospective Study with a Patency Capsule and Computed Tomography
dc.creator.none.fl_str_mv Silva,Marco
Cardoso,Hélder
Cunha,Rui
Peixoto,Armando
Gaspar,Rui
Gomes,Sara
Santos,Ana Luísa
Lopes,Susana
Macedo,Guilherme
dc.format.none.fl_str_mv text/html
dc.identifier.none.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000600003
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Gastrenterologia
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.source.none.fl_str_mv GE-Portuguese Journal of Gastroenterology v.26 n.6 2019
dc.subject.none.fl_str_mv Inflammatory bowel disease
Diagnosis and imaging
Small-bowel endoscopy
Capsule endoscopy
Gastrointestinal radiology
dc.title.fl_str_mv Evaluation of Small-Bowel Patency in Crohn’s Disease: Prospective Study with a Patency Capsule and Computed Tomography
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description Background and Purpose: Patency capsule (PC) examination is usually performed - previously to capsule endoscopy - to evaluate small-bowel patency in patients with established Crohn’s disease (CD). The reported PC retention rate is significantly higher than expected. Our aims were to assess small-bowel patency, to determine the precise location of the retained PC in patients with CD, and to determine the false positive rate of evaluation with a radiofrequency identification tag (RFIT) scanner. Methods: This is a prospective single-center study including CD patients with clinical indication for small-bowel capsule endoscopy. PillCam® PC examination was performed on all patients to assess smallbowel patency. On all patients with a positive identification of the PC using an RFIT scanner, 30 h after ingestion, an abdominal CT was performed in order to identify its precise location. Results: Fifty-four patients were included. The PC retention rate, according to evaluation with the RFIT scanner, was 20% (in 11 patients) 30 h after ingestion. These patients were then submitted to abdominal CT, which revealed that there was small-bowel retention in 5 cases (9%). Higher CRP levels, penetrating disease, and a history of abdominal surgery were associated with an increased risk of PC retention (p = 0.007, p = 0.011, and p = 0.033, respectively). On multivariate analysis, there was an independent association between small-bowel PC retention and CRP levels > 5 mg/dL (OR = 15.5; p = 0.03). Discussion: The small-bowel PC retention rate (9%) was considerably lower than those found in previous reports. Our results show that, with this protocol, the false-positive cases of RFIT scans or plain abdominal Xrays may be avoided. This may contribute to more extensive application of capsule endoscopy without the risk of smallbowel retention.
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person_str_mv Silva,Marco
Cardoso,Hélder
Cunha,Rui
Peixoto,Armando
Gaspar,Rui
Gomes,Sara
Santos,Ana Luísa
Lopes,Susana
Macedo,Guilherme
publishDate 2019
publisher.none.fl_str_mv Sociedade Portuguesa de Gastrenterologia
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spelling Evaluation of Small-Bowel Patency in Crohn’s Disease: Prospective Study with a Patency Capsule and Computed TomographySilva,MarcoCardoso,HélderCunha,RuiPeixoto,ArmandoGaspar,RuiGomes,SaraSantos,Ana LuísaLopes,SusanaMacedo,GuilhermeInflammatory bowel diseaseDiagnosis and imagingSmall-bowel endoscopyCapsule endoscopyGastrointestinal radiologyopen accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000600003URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000600003URLHasVersion2019-12-01Background and Purpose: Patency capsule (PC) examination is usually performed - previously to capsule endoscopy - to evaluate small-bowel patency in patients with established Crohn’s disease (CD). The reported PC retention rate is significantly higher than expected. Our aims were to assess small-bowel patency, to determine the precise location of the retained PC in patients with CD, and to determine the false positive rate of evaluation with a radiofrequency identification tag (RFIT) scanner. Methods: This is a prospective single-center study including CD patients with clinical indication for small-bowel capsule endoscopy. PillCam® PC examination was performed on all patients to assess smallbowel patency. On all patients with a positive identification of the PC using an RFIT scanner, 30 h after ingestion, an abdominal CT was performed in order to identify its precise location. Results: Fifty-four patients were included. The PC retention rate, according to evaluation with the RFIT scanner, was 20% (in 11 patients) 30 h after ingestion. These patients were then submitted to abdominal CT, which revealed that there was small-bowel retention in 5 cases (9%). Higher CRP levels, penetrating disease, and a history of abdominal surgery were associated with an increased risk of PC retention (p = 0.007, p = 0.011, and p = 0.033, respectively). On multivariate analysis, there was an independent association between small-bowel PC retention and CRP levels > 5 mg/dL (OR = 15.5; p = 0.03). Discussion: The small-bowel PC retention rate (9%) was considerably lower than those found in previous reports. Our results show that, with this protocol, the false-positive cases of RFIT scans or plain abdominal Xrays may be avoided. This may contribute to more extensive application of capsule endoscopy without the risk of smallbowel retention.Sociedade Portuguesa de GastrenterologiaGE-Portuguese Journal of Gastroenterology v.26 n.6 2019text/htmlengjournal articlehttp://purl.org/coar/resource_type/c_6501literature
spellingShingle Evaluation of Small-Bowel Patency in Crohn’s Disease: Prospective Study with a Patency Capsule and Computed Tomography
Silva,Marco
Inflammatory bowel disease
Diagnosis and imaging
Small-bowel endoscopy
Capsule endoscopy
Gastrointestinal radiology
status SINGLETON
subject.fl_str_mv Inflammatory bowel disease
Diagnosis and imaging
Small-bowel endoscopy
Capsule endoscopy
Gastrointestinal radiology
title Evaluation of Small-Bowel Patency in Crohn’s Disease: Prospective Study with a Patency Capsule and Computed Tomography
title_full Evaluation of Small-Bowel Patency in Crohn’s Disease: Prospective Study with a Patency Capsule and Computed Tomography
title_fullStr Evaluation of Small-Bowel Patency in Crohn’s Disease: Prospective Study with a Patency Capsule and Computed Tomography
title_full_unstemmed Evaluation of Small-Bowel Patency in Crohn’s Disease: Prospective Study with a Patency Capsule and Computed Tomography
title_short Evaluation of Small-Bowel Patency in Crohn’s Disease: Prospective Study with a Patency Capsule and Computed Tomography
title_sort Evaluation of Small-Bowel Patency in Crohn’s Disease: Prospective Study with a Patency Capsule and Computed Tomography
topic Inflammatory bowel disease
Diagnosis and imaging
Small-bowel endoscopy
Capsule endoscopy
Gastrointestinal radiology
topic_facet Inflammatory bowel disease
Diagnosis and imaging
Small-bowel endoscopy
Capsule endoscopy
Gastrointestinal radiology
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452019000600003
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