Spada Cristiano, Shah Saumil K, Riccioni Maria Elena, Spera Gianluca, Marchese Michele, Iacopini Federico, Familiari Pietro, Costamagna Guido
Digestive Endoscopy Unit, Catholic University, Rome, Italy.
J Clin Gastroenterol. 2007 Jul;41(6):576-82. doi: 10.1097/01.mcg.0000225633.14663.64.
To assess the safety of the Pillcam in patients with known or suspected radiologic stricture, previously tested for small bowel patency using the Given Patency capsule.
Intestinal stricture contributes a major contraindication to video capsule endoscopy (VCE), because of the risk of capsule retention.
Twenty-seven patients (16 female, mean age 44.2 y) with known or suspected intestinal stricture were enrolled prospectively. Twenty-four had Crohn's disease, 2 had adhesive syndrome and 1 had a suspected ischemic stricture. Patients underwent the Patency capsule test. In patients in whom the Patency capsule was excreted intact within 72 hours postingestion without occurrence of any adverse event, VCE was performed to assess the presence of strictures or other gastrointestinal pathologies. The following parameters were evaluated: transit time of Patency capsules and/or tags from ingestion to excretion, condition of the Patency capsule at excretion, transit time of the Pillcam capsule, the ability of Pillcam capsule to detect intestinal strictures and small bowel pathologies, any adverse events.
Twenty-five patients (92.6%) retrieved the Patency capsule in the stools. Six patients complained of abdominal pain, 4 of whom excreted a nonintact capsule. Hospitalization was required in 1 (4.3%) patient with Crohn's disease due to occlusive syndrome. Fifteen patients (65.3%) excreted an intact Patency capsule after a mean transit time of 25.6 hours without any adverse events. These 15 patients underwent the VCE successfully.
Passage of an intact Patency capsule across a small bowel stricture provides direct evidence of functional patency of the gut lumen and allows a safe VCE. Intestinal strictures should not be considered an absolute contraindication for VCE.
评估已知或疑似存在放射学狭窄、先前已使用 Given 通畅胶囊进行小肠通畅性测试的患者中 Pillcam 的安全性。
由于存在胶囊滞留风险，肠道狭窄是视频胶囊内镜检查（VCE）的主要禁忌证。
前瞻性纳入 27 例已知或疑似肠道狭窄的患者（16 例女性，平均年龄 44.2 岁）。24 例患有克罗恩病，2 例患有粘连综合征，1 例疑似缺血性狭窄。患者接受通畅胶囊测试。在摄入通畅胶囊后 72 小时内完整排出且未发生任何不良事件的患者中，进行 VCE 以评估是否存在狭窄或其他胃肠道病变。评估了以下参数：通畅胶囊和/或标记物从摄入到排出的转运时间、排出时通畅胶囊的状况、Pillcam 胶囊的转运时间、Pillcam 胶囊检测肠道狭窄和小肠病变的能力、任何不良事件。
25 例患者（92.6%）在粪便中找回了通畅胶囊。6 例患者抱怨腹痛，其中 4 例排出的胶囊不完整。1 例（4.3%）患有克罗恩病的患者因闭塞综合征需要住院治疗。15 例患者（65.3%）在平均转运时间为 25.6 小时后排出完整的通畅胶囊，且未发生任何不良事件。这 15 例患者成功接受了 VCE。
完整的通畅胶囊通过小肠狭窄提供了肠腔功能通畅的直接证据，并允许安全地进行 VCE。肠道狭窄不应被视为 VCE 的绝对禁忌证。
