Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Mucosal Changes in the Small Intestines in Portal Hypertension: First Study Using the Pillcam SB3 Capsule Endoscopy System

  • Goenka, Mahesh Kumar (Institute of Gastro-Sciences, Apollo Gleneagles Hospitals) ;
  • Shah, Bhavik Bharat (Institute of Gastro-Sciences, Apollo Gleneagles Hospitals) ;
  • Rai, Vijay Kumar (Institute of Gastro-Sciences, Apollo Gleneagles Hospitals) ;
  • Jajodia, Surabhi (Department of Clinical Imaging and Interventional Radiology, Apollo Gleneagles Hospitals) ;
  • Goenka, Usha (Department of Clinical Imaging and Interventional Radiology, Apollo Gleneagles Hospitals)
  • Received : 2018.02.21
  • Accepted : 2018.07.18
  • Published : 2018.11.30
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Abstract

Background/Aims: To evaluate patients with portal hypertension (PH) of varied etiologies for portal hypertensive enteropathy (PHE) using the PillCam SB3 capsule endoscopy (CE) system. Methods: Consecutive patients with PH presenting with unexplained anemia and/or occult gastrointestinal bleeding were evaluated using the PillCam SB3 CE system. Abnormal findings were categorized as vascular or non-vascular. The patients with ongoing bleeding caused by PHE were treated. The correlation of the CE scores of PHE with the clinical, laboratory, and endoscopic features was determined. Results: Of the 43 patients included in the study, 41 (95.3%) showed PHE findings. These included varices (67.4%), red spots (60.5%), erythema (44.2%), villous edema (46.5%), telangiectasia (16.3%), and polyps (16.3%). The CE scores varied from 0 to 8 ($mean{\pm}standard$ deviation, $4.09{\pm}1.8$). Five patients (11.6%) showed evidence of ongoing or recent bleeding due to PHE. Three of these five patients underwent endotherapy, and one patient underwent radiological coil placement. Conclusions: The PillCam SB3 CE system revealed a high prevalence of PHE in the patients with PH. Using this system, evidence of bleeding due to PHE was found in a small but definite proportion of the patients.

Keywords

References

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