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Small bowel enteroclysis with magnetic resonance imaging and computed tomography in patients with failed and uncertain passage of a patency capsule

Fork, Frans Thomas ; Karlsson, Nils ; Kadhem, Sattar and Ohlsson, Bodil LU (2012) In BMC Medical Imaging 12.
Abstract

Background: Video capsule enteroscopy (VCE) has revolutionized small bowel imaging, enabling visual examination of the mucosa of the entire small bowel, while MR enteroclysis (MRE) and CT enteroclysis (CTE) have largely replaced conventional barium enteroclysis. A new indication for MRE and CTE is the clinical suspicion of small bowel strictures, as indicated by delayed or non-delivery of a test capsule given before a VCE examination, to exclude stenosis. The aim of this study was to determine the clinical value of subsequent MRE and CTE in patients in whom a test capsule did not present itself in due time.Methods: Seventy-five consecutive patients were identified with a delayed or unnoticed delivery of the test capsule. Seventy... (More)

Background: Video capsule enteroscopy (VCE) has revolutionized small bowel imaging, enabling visual examination of the mucosa of the entire small bowel, while MR enteroclysis (MRE) and CT enteroclysis (CTE) have largely replaced conventional barium enteroclysis. A new indication for MRE and CTE is the clinical suspicion of small bowel strictures, as indicated by delayed or non-delivery of a test capsule given before a VCE examination, to exclude stenosis. The aim of this study was to determine the clinical value of subsequent MRE and CTE in patients in whom a test capsule did not present itself in due time.Methods: Seventy-five consecutive patients were identified with a delayed or unnoticed delivery of the test capsule. Seventy patients consented to participate and underwent MRE (44) or CTE (26). The medical records and imaging studies were retrospectively reviewed and symptoms, laboratory results and imaging findings recorded.Results: Lesions compatible with Crohns disease were shown by MRE in 5 patients, by CTE in one and by VCE in four, one of whom had lesions on MRE. In patients without alarm symptoms and findings (weight loss, haematochezia, anaemia, nocturnal diarrheoa, ileus, fistula, abscess and abnormal blood tests) imaging studies did not unveil any such lesion. VCE's were performed in only 20 patients, mainly younger than 50 years of age, although no stenotic lesion was shown by MRE and CTE. In the remaining 50 patients no VCE or other endoscopic intervention was performed indicating that the referring physician was content with the diagnostic information from MRE or CTE.Conclusion: The diagnostic value of MRE and CTE is sufficient for clinical management of most patients with suspected small bowel disease, and thus VCE may be omitted or at least postponed for later usage.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Computed tomography, Enteroclysis, Magnetic resonance imaging, Patency capsule, Small bowel, Video capsule enteroscopy
in
BMC Medical Imaging
volume
12
article number
3
publisher
BioMed Central (BMC)
external identifiers
  • pmid:22336074
  • scopus:84856991337
ISSN
1471-2342
DOI
10.1186/1471-2342-12-3
language
English
LU publication?
yes
id
552441a8-4c78-4d47-a4ff-2a0d5f0d67b0
date added to LUP
2020-09-14 13:47:43
date last changed
2024-03-05 11:06:22
@article{552441a8-4c78-4d47-a4ff-2a0d5f0d67b0,
  abstract     = {{<p>Background: Video capsule enteroscopy (VCE) has revolutionized small bowel imaging, enabling visual examination of the mucosa of the entire small bowel, while MR enteroclysis (MRE) and CT enteroclysis (CTE) have largely replaced conventional barium enteroclysis. A new indication for MRE and CTE is the clinical suspicion of small bowel strictures, as indicated by delayed or non-delivery of a test capsule given before a VCE examination, to exclude stenosis. The aim of this study was to determine the clinical value of subsequent MRE and CTE in patients in whom a test capsule did not present itself in due time.Methods: Seventy-five consecutive patients were identified with a delayed or unnoticed delivery of the test capsule. Seventy patients consented to participate and underwent MRE (44) or CTE (26). The medical records and imaging studies were retrospectively reviewed and symptoms, laboratory results and imaging findings recorded.Results: Lesions compatible with Crohns disease were shown by MRE in 5 patients, by CTE in one and by VCE in four, one of whom had lesions on MRE. In patients without alarm symptoms and findings (weight loss, haematochezia, anaemia, nocturnal diarrheoa, ileus, fistula, abscess and abnormal blood tests) imaging studies did not unveil any such lesion. VCE's were performed in only 20 patients, mainly younger than 50 years of age, although no stenotic lesion was shown by MRE and CTE. In the remaining 50 patients no VCE or other endoscopic intervention was performed indicating that the referring physician was content with the diagnostic information from MRE or CTE.Conclusion: The diagnostic value of MRE and CTE is sufficient for clinical management of most patients with suspected small bowel disease, and thus VCE may be omitted or at least postponed for later usage.</p>}},
  author       = {{Fork, Frans Thomas and Karlsson, Nils and Kadhem, Sattar and Ohlsson, Bodil}},
  issn         = {{1471-2342}},
  keywords     = {{Computed tomography; Enteroclysis; Magnetic resonance imaging; Patency capsule; Small bowel; Video capsule enteroscopy}},
  language     = {{eng}},
  month        = {{02}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Medical Imaging}},
  title        = {{Small bowel enteroclysis with magnetic resonance imaging and computed tomography in patients with failed and uncertain passage of a patency capsule}},
  url          = {{http://dx.doi.org/10.1186/1471-2342-12-3}},
  doi          = {{10.1186/1471-2342-12-3}},
  volume       = {{12}},
  year         = {{2012}},
}