Using capsule endoscopy to identify GI tract lesions in cirrhotic patients with portal hypertension and chronic anemia

Karen R Canlas; Brian M Dobozi; Sauyu Lin; Alastair D Smith; Don C Rockey; Andrew J Muir; Naurang M Agrawal; Martin H Poleski; Keyur Patel; John G McHutchison

doi:10.1097/MCG.0b013e318038d312

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Using capsule endoscopy to identify GI tract lesions in cirrhotic patients with portal hypertension and chronic anemia

Journal article

Peer reviewed

Using capsule endoscopy to identify GI tract lesions in cirrhotic patients with portal hypertension and chronic anemia

Karen R Canlas, Brian M Dobozi, Sauyu Lin, Alastair D Smith, Don C Rockey, Andrew J Muir, Naurang M Agrawal, Martin H Poleski, Keyur Patel and John G McHutchison

Journal of clinical gastroenterology, Vol.42(7), pp.844-848

08/2008

DOI: 10.1097/MCG.0b013e318038d312

PMID: 18277884

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Abstract

We aimed to evaluate the ability of capsule endoscopy (CE) to detect small intestine (SI) lesions, especially SI varices, in patients with intrahepatic cirrhosis, portal hypertension (PHTN), and chronic anemia. Gastroesophageal variceal bleeding is a well-recognized complication of cirrhosis and PHTN, yet methods of identifying lesions in the SI that may contribute to covert bleeding and anemia, such as small bowel enteroscopy and angiography, are invasive and may be inadequate. In this observational pilot study, 19 consecutive patients presenting to a tertiary care, liver transplantation referral center with cirrhosis, PHTN, and chronic anemia after obliterative esophageal variceal therapy were evaluated with wireless CE using the GIVEN Pillcam SB M2A capsule. Two independent and blinded examiners reviewed the CE examinations. SI varices were identified in 15.8% (3/19) of patients. Other PHTN-related findings included portal hypertensive gastropathy (13/19, 68.4%), portal hypertensive enteropathy (12/19, 63.1%), and portal hypertensive colopathy (3/19, 15.8%). Two patients had nonbleeding esophageal varices (2/19, 10.5%). A potential source of gastrointestinal blood loss was identified in 89.5% (17/19) of patients. Active bleeding sites were identified in 15.8% (3/19). CE can identify potential bleeding sources and could have diagnostic utility in patients with end-stage liver disease and chronic anemia after obliterative esophageal variceal therapy.

Intestine, Small - pathology

Hypertension, Portal - complications

Hypertension, Portal - pathology

Liver Cirrhosis - complications

Humans

Middle Aged

Capsule Endoscopy

Anemia - pathology

Male

Gastrointestinal Hemorrhage - diagnosis

Anemia - complications

Liver Cirrhosis - pathology

Adult

Female

Esophageal and Gastric Varices - diagnosis

Details

Title: Subtitle: Using capsule endoscopy to identify GI tract lesions in cirrhotic patients with portal hypertension and chronic anemia
Creators: Karen R Canlas - Division of Gastroenterology and Hepatology, Duke University Medical Center, Durham, NC 27705, USA
Brian M Dobozi
Sauyu Lin
Alastair D Smith
Don C Rockey
Andrew J Muir
Naurang M Agrawal
Martin H Poleski
Keyur Patel
John G McHutchison
Resource Type: Journal article
Publication Details: Journal of clinical gastroenterology, Vol.42(7), pp.844-848
DOI: 10.1097/MCG.0b013e318038d312
PMID: 18277884
ISSN: 0192-0790
eISSN: 1539-2031
Language: English
Date published: 08/2008
Academic Unit: Gastroenterology and Hepatology; Internal Medicine
Record Identifier: 9984094355102771

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38 Times Cited - Web of Science