Davis Brian R, Harris Hobart, Vitale Gary C
Department of Surgery, University of Louisville, Louisville, KY 40292, USA.
Surg Innov. 2005 Jun;12(2):129-33. doi: 10.1177/155335060501200210.
Occult gastrointestinal bleeding and lesions associated with inflammatory bowel disease represent a diagnostic dilemma because they often lie in areas of the small bowel that are difficult to access with flexible fiberoptic endoscopy. Capsule endoscopy has been developed to access these areas in a way that avoids the pain and anesthesia risks of push endoscopy. The diagnostic yield of capsule endoscopy has proven to be superior to both flexible small-bowel endoscopy and radiologic studies in several prospective trials. Capsule endoscopy transmits a large number of images that do not correlate well with the standard endoscopic view, creating a diagnostic challenge for the endoscopist. Complications of this procedure include capsule retention in diverticulae or at stricture sites. The technology of this procedure continues to evolve through improving image resolution and diagnostic accuracy. Capsule endoscopy also represents an overall economic saving despite a high unit price compared with the expense of repeat diagnostic testing. Because the diagnostic yield of capsule endoscopy is nearly twofold greater than conventional endoscopy, it has become the procedure of choice for the dilemma of assessing small-bowel pathology for many clinicians. Further studies are needed to determine whether the capsule endoscope can replace conventional endoscopy in the first-line diagnosis of pathology in other parts of the alimentary tract.
隐匿性胃肠道出血以及与炎症性肠病相关的病变构成了一个诊断难题，因为它们常常位于小肠中难以通过可弯曲纤维内镜检查触及的区域。胶囊内镜已被开发出来，以一种避免推进式内镜检查的疼痛和麻醉风险的方式来检查这些区域。在多项前瞻性试验中，胶囊内镜的诊断率已被证明优于可弯曲小肠内镜检查和放射学检查。胶囊内镜传输大量与标准内镜视野相关性不佳的图像，给内镜医师带来了诊断挑战。该检查的并发症包括胶囊滞留于憩室或狭窄部位。通过提高图像分辨率和诊断准确性，该检查技术在不断发展。尽管与重复诊断检测的费用相比，胶囊内镜单价较高，但总体上仍节省了费用。由于胶囊内镜的诊断率几乎比传统内镜高一倍，对于许多临床医生而言，它已成为评估小肠病变难题时的首选检查方法。还需要进一步研究来确定胶囊内镜在消化道其他部位病变的一线诊断中能否取代传统内镜检查。
