Teramoto Matsubara Oscar, Zamarripa Dorsey Felipe, López Acosta María Elena
Servicio de Fisiología Digestiva, Hospital Angeles de las Lomas, Huixquilucan, Estado de Mexico.
Rev Gastroenterol Mex. 2005 Apr-Jun;70(2):138-42.
Wireless capsule endoscopy is a diagnostic procedure to study the pathology of the small intestine physiologically and painlessly. The capsule dimensions are 11 x 26 mm, and takes 2 picture per second whilst 8 hours. Unexplained occult gastrointestinal tract bleeding is the main indication, but everyday new indications for its use come to the literature. Our objective were to review our experience about the clinical usefulness and impact in our clinic. We included 45 cases, excluding 3 because of technical problems. There were 24 women and 18 men, with an average age of 54 years old (18 to 86 years old). Indications for the study were: Gastrointestinal bleeding of obscure origin in 24 cases, anemia in 6 cases, chronic diarrhea in 8 cases, chronic abdominal pain in 2 cases and Crohn's disease in 2 cases. The source of bleeding in the first group was identified in 18 patients (75%), where jejunal and ileal angiodysplasias were found in 11 patients, in 4 cases there were ulcers or erosions, in one case a Meckel diverticulum was found and, in the last one an hammartomatous lesion with an active bleeding was found. In chronic diarrhea patients a lesion was found in 5 cases (62.5%), where mucosal atrophy were found in two patients who responded to a free gluten diet, and in 3 patients acute inflammations with ulcers were treated as Crohn's disease. In the patients with anemia a lesion was found in 2 cases (33%), where a submucosal tumor and a jejunal ulcer were the findings. No lesions were found in the patients with chronic abdominal pain. Finally in the patients with Crohn's disease we were able to know the extent and one patient presented two stenotic lesions. In conclusion, wireless capsule endoscopy is a useful diagnostic tool that let us study easily the small intestine and should be integrated to different study protocols as gastrointestinal bleeding of obscure origin, chronic diarrhea and evaluation of Crohn's disease. It is not useful for abdominal pain, nevertheless we just studied two patients.
无线胶囊内镜检查是一种用于生理且无痛地研究小肠病理的诊断程序。胶囊尺寸为11×26毫米，在8小时内每秒拍摄2张图片。不明原因的隐匿性胃肠道出血是主要适应症，但每天都有其新的应用适应症出现在文献中。我们的目的是回顾我们在临床应用中的经验及其影响。我们纳入了45例病例，因技术问题排除3例。其中女性24例，男性18例，平均年龄54岁（18至86岁）。研究适应症包括：不明原因的胃肠道出血24例，贫血6例，慢性腹泻8例，慢性腹痛2例，克罗恩病2例。第一组中18例患者（75%）明确了出血来源，其中11例发现空肠和回肠血管发育异常，4例有溃疡或糜烂，1例发现梅克尔憩室，最后1例发现有活动性出血的错构瘤性病变。慢性腹泻患者中5例（62.5%）发现病变，其中2例对无麸质饮食有反应的患者发现黏膜萎缩，3例急性炎症伴溃疡的患者按克罗恩病治疗。贫血患者中2例（33%）发现病变，发现的病变为1例黏膜下肿瘤和1例空肠溃疡。慢性腹痛患者未发现病变。最后，在克罗恩病患者中我们能够了解病变范围，1例患者出现两处狭窄性病变。总之，无线胶囊内镜检查是一种有用的诊断工具，能让我们轻松研究小肠，应纳入不同的研究方案，如不明原因的胃肠道出血、慢性腹泻和克罗恩病的评估。它对腹痛无用，不过我们仅研究了2例患者。
