THE SMALL BOWEL VIDEO CAPSULE ENDOSCOPY - TEN YEARS EXPERIENCE IN LATVIA

Abstract

Introduction: Video capsule endoscopy (VCE) is relatively new, informative and minimally invasive endoscopic diagnostic method for assessment of the small bowel mucosa.

Objective: To evaluate the clinical significance of ten years' experience of VCE in Latvia.

Materials and methods: A retrospective review of patients who underwent VCE between July 2006 and July 2016 was conducted. All patients had undergone previous negative endoscopic examinations before VCE. Special original study protocol with more than 370 parameters was fulfilled for each patient. All the data was entered into the database with consecutive statistical analysis using SPSS ver.19.

Results: In total out of 530 VCE were performed, due to technical reasons 421 patients' data were entered into the database. Out of these, 245 (58,2%) patients were females and 176 (41,8%) - males. Patients' age was varied from 13 to 82 (mean 44.39 ± 16.36) years. VCE most common indications were: Crohn's disease (26.1%), unclear iron deficiency anemia (22.8%), chronic unexplained abdominal pain (20.4%) and obscure bleeding from the digestive tract (17.1%). VCE findings were justified as clinically significant in 255 (60.57%) of cases. In 152 (36.10%) - findings were doubtful, and in 14 (3.33%) - clinically insignificant. Bowel preparation prior to capsule endoscopy was performed using one of the four schemes. Bowel cleanliness was statistically significantly better (p = 0.03) using 2 liters or 4 liters of polyethylene glycol-based electrolyte solution. Regional transit abnormalities (RTA) in 55 (13.1%) cases. Positive statistically significant correlation was observed between presence of RTA without changes / defects in the small bowel mucosa and patients age (p = 0.028).

Conclusions: 1. VCE is clinically significant examination in patients with Crohn's disease, obscure bleeding from the digestive tract, unexplained anemia and chronic unexplained abdominal pain, which also allows changing the patient's further treatment tactics. 2. 2 liters and 4 liters of polyethylene glycol-based electrolyte solution are by far the most efficient bowel preparation schemes prior VCE. 3. RTA is more common in the elderly patients.