II. Indications
-
Obscure Gastrointestinal Bleeding
- Presumed Small Intestinal Bleeding
- Blood loss Anemia and normal standard endoscopy
- Non-bleeding indications
- Suspected Crohn's Disease
- Suspected Small Bowel tumor
- Abnormal imaging study of the Small Bowel
- Refractory Celiac Sprue
- Familial Adenomatous Polyposis Syndrome
III. Contraindications
- Swallowing Disorders
- Pacemaker or other implantable electromedical device
- Small Bowel Obstruction, strictures or fistulas
- Pregnancy
IV. Technique
- Preparation
- Fast for 10 hours and no purging or
- Two liter PEG given 6 hours before capsule or
- Single dose of Simethicone before procedure
- Patient swallows disposable wireless video capsule
- Capsule is 2.6 x 1.1 cm in size (PillCam ESO)
- Capsule has 6-8 hour battery life
- Capsule contains microchip camera and light source
- Patient wears recorder
- Camera transmits 2 images per second to recorder
V. Complications
- Stool impaction
- Small Bowel stricture
- Retention of pill camera
VI. Efficacy
- Overall, capsule misses 36% of lesions
- Identifies bleeding source in 55-76%
- Contrast with push endoscopy sensitivity: 21-38%
- Accurate in Crohn's Disease diagnosis