Where does capsule endoscopy fit in the diagnostic algorithm of small bowel intussusception?

Area of Science:

• Gastroenterology
• Diagnostic Imaging
• Endoscopy

Background:

• Small bowel (SB) intussusception diagnosis lacks standardized approaches.
• Small bowel capsule endoscopy (SBCE) role in investigating SB intussusception requires clarification.

Purpose of the Study:

• To evaluate the utility of SBCE in diagnosing small bowel intussusception.
• To understand the diagnostic yield of SBCE compared to radiological investigations.

Main Methods:

• Retrospective multi-center study including 95 patients with intussusception identified on SBCE or prior radiological imaging.
• Analysis of SBCE findings in conjunction with radiological investigations (CT, etc.).

Main Results:

• SBCE identified abnormalities explaining intussusception in 22.5% of patients.
• In 42.2% of cases with radiological intussusception, SBCE was normal.
• Repeat radiology after negative SBCE rarely yielded positive findings (14.1%).
• SBCE identified masses in 4.2% of patients, leading to surgery.

Conclusions:

• SBCE serves as a valuable adjunct to radiology for small bowel intussusception.
• SBCE can minimize unnecessary surgical interventions.
• Further radiological investigations after a negative SBCE for intussusception are generally not productive.