Role of capsule endoscopy in small bowel management
Författare
Summary, in English
The aim of this thesis is to increase the knowledge and critically evaluate the use of VCE and its capability to diagnose small bowel Crohn's disease and to explore the most concerning complication of VCE - capsule retention. Specific aims were to explore the risk of capsule retention, to evaluate the clinical impact and the
value of the patency capsule test on the risk of capsule retention, to describe the clinical impact of VCE in patients with established Crohn's disease and to examine the impact and safety of VCE performed in children.
The usefulness and risk of VCE was evaluated in different clinical situations. The studies were performed using three different models of small bowel capsule endoscopes. Patency capsule examinations were performed using
a first or a second generation patency capsule.
The studies demonstrate that capsule retention is a rare complication of VCE. Moreover, a majority of patients with capsule retention can be safely and effectively managed with endoscopic intervention instead of surgery.
The results suggest that routine nonselective administration of the patency capsule before VCE in patients with established Crohn's disease is not likely to reduce the risk of video capsule retention. VCE provides meaningful
results leading to therapeutic changes in more than 50% of patients with established Crohn's disease. VCE is a safe method and often leads to a definitive diagnosis and has a significant impact on the clinical management of
pediatric patients with Crohn's disease.
Taken together, VCE has a high capability to diagnose small bowel Crohn's disease and is a very safe method to investigate the small bowel mucosa. The few cases with capsule retention can be mostly managed with endoscopic intervention.
Avdelning/ar
Publiceringsår
2019
Språk
Engelska
Publikation/Tidskrift/Serie
'Lund University, Faculty of Medicine Doctoral Dissertation Series
Volym
2019
Issue
26
Fulltext
Dokumenttyp
Doktorsavhandling
Förlag
Lund University: Faculty of Medicine
Ämne
- Gastroenterology and Hepatology
Nyckelord
- Capsule endoscopy
- Crohn's disease,
- Patency capsule
- small bowel
- Capsule retention
Status
Published
Forskningsgrupp
- Surgery
Handledare
ISBN/ISSN/Övrigt
- ISSN: 1652-8220
- ISBN: 978-91-7619-755-4
Försvarsdatum
29 mars 2019
Försvarstid
09:00
Försvarsplats
Lilla aulan, Jan Waldenströms gata 5, Skånes Universitetssjukhus i Malmö
Opponent
- Hans Strid (docent)