Webbläsaren som du använder stöds inte av denna webbplats. Alla versioner av Internet Explorer stöds inte längre, av oss eller Microsoft (läs mer här: * https://www.microsoft.com/en-us/microsoft-365/windows/end-of-ie-support).

Var god och använd en modern webbläsare för att ta del av denna webbplats, som t.ex. nyaste versioner av Edge, Chrome, Firefox eller Safari osv.

Role of capsule endoscopy in small bowel management

Författare

Summary, in English

The small bowel is difficult to reach and to examine endoscopically. Video capsule endoscopy (VCE) using a wireless imaging technology was introduced 2000. VCE is an ingestible capsule camera that takes photographs during its passage throughout the gastrointestinal tract. The diagnosis of small bowel Crohn's disease is among the prime indications for VCE, as one third of patients with Crohn's disease have only small bowel involvement.
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

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

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)