Related Experiment Video
Updated: Jul 2, 2025
Murine Endoscopy for In Vivo Multimodal Imaging of Carcinogenesis and Assessment of Intestinal Wound Healing and Inflammation
Published on: August 26, 2014
Pan-intestinal capsule endoscopy as first-line procedure in patients with suspected mid or lower gastrointestinal
Bruno Rosa1,2,3, Tiago Cúrdia Gonçalves1,2,3, Maria J Moreira1,2,3
1Department of Gastroenterology, Hospital da Senhora da Oliveira, Guimarães, Portugal.
Background:
Pan-intestinal capsule endoscopy (PCE) evaluates the small bowel and colon noninvasively. This study evaluated diagnostic accuracy and safety of PCE vs. colonoscopy as first-line examination in suspected mid-lower gastrointestinal bleeding (MLGIB).
Methods:
In this prospective, single-center, single-blinded cohort study, consecutive patients with suspected MLGIB underwent PCE followed by same-day colonoscopy. Diagnostic accuracy for potentially hemorrhagic lesions (PHLs; combined diagnosis by PCE + colonoscopy) and incidence of adverse events were assessed.
Results:
100 patients were included (median age 70 [range 18-92] years; 65% female). PHLs were diagnosed in 46 patients, including small-bowel and/or colon angioectasias in 32. PCE correctly identified 54 individuals without PHLs, and 95.7% (44/46) of those with PHLs vs. 50.0% (23/46) for colonoscopy (P<0.01). PHLs were detected by PCE alone in 65.2% (30/46), both examinations in 28.3% (13/46), and colonoscopy alone in 6.5% (3/46). PHLs were diagnosed at the ileocolonic region in 28% of patients, with PCE diagnosing 25/28 cases (89.3%) and colonoscopy diagnosing 23/28 (82.1%; P=0.13). Interventional procedures were performed at colonoscopy in 13/81 patients with iron-deficiency anemia (16.0%) vs. 6/19 patients with overt bleeding (31.6%; P<0.01). No significant adverse events occurred with PCE vs. 2% with colonoscopy.
Conclusions:
In patients with MLGIB, PCE avoided further invasive procedures in >50% of patients. PCE was safe and more effective than colonoscopy in identifying PHL both in the small bowel and colon. These results support the potential use of PCE as first-line examination in patients with suspected MLGIB.
Insights
Pan-intestinal capsule endoscopy (PCE) is a safe and effective first-line tool for diagnosing mid-lower gastrointestinal bleeding (MLGIB). PCE significantly outperformed colonoscopy in identifying potentially hemorrhagic lesions (PHLs), avoiding invasive procedures for many patients.
Area of Science:
- Gastroenterology
- Medical Imaging
- Diagnostic Endoscopy
Background:
- Pan-intestinal capsule endoscopy (PCE) offers noninvasive evaluation of the small bowel and colon.
- Mid-lower gastrointestinal bleeding (MLGIB) necessitates accurate diagnostic methods.
- Comparing PCE and colonoscopy as initial diagnostic approaches for MLGIB is crucial.
Purpose of the Study:
- To evaluate the diagnostic accuracy of PCE compared to colonoscopy for suspected MLGIB.
- To assess the safety profile of PCE versus colonoscopy in this patient population.
- To determine the efficacy of PCE as a first-line examination for MLGIB.
Main Methods:
- Prospective, single-center, single-blinded cohort study.
- 100 patients with suspected MLGIB underwent PCE followed by same-day colonoscopy.
- Diagnostic accuracy for potentially hemorrhagic lesions (PHLs) and adverse events were assessed.
Main Results:
- PCE identified 95.7% of PHLs, significantly higher than colonoscopy's 50.0% (P<0.01).
- PCE alone detected 65.2% of PHLs, while colonoscopy alone detected 6.5%.
- No significant adverse events occurred with PCE, compared to 2% with colonoscopy; PCE avoided further invasive procedures in over 50% of patients.
Conclusions:
- PCE is a safe and more effective diagnostic tool than colonoscopy for identifying PHLs in both the small bowel and colon.
- PCE demonstrated superior diagnostic performance in patients with MLGIB.
- These findings support PCE's utility as a first-line examination for suspected MLGIB.
Related Concept Videos
01:28Endoscopic Procedures III: Video Capsule Endoscopy
01:26Endoscopic Procedures V: ERCP
Patient...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:25Endoscopic Procedures II: Colonoscopy
01:23Lower GI Series: Barium Enema
Procedure Details
The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to: