[Diagnostic utility of small-bowel capsule endoscopy in patients with gastrointestinal symptoms after allogeneic hematopoietic cell transplantation].

We retrospectively evaluated the safety and diagnostic utility of small bowel capsule endoscopy (SBCE) in 45 patients (66 procedures) who developed gastrointestinal symptoms after allogeneic hematopoietic cell transplantation (allo-HCT). Despite a high proportion of patients with poor performance status (≥2: 43 procedures) and thrombocytopenia (platelet counts <20,000/µl in 10 procedures, <50,000/µl in 25 procedures), which are generally considered high-risk conditions for conventional esophagogastroduodenoscopy (EGD) and colonoscopy (CS), SBCE demonstrated a 0% adverse event rate and 89.2% complete small bowel observation rate, which are comparable to outcomes previously reported in non-transplant patients. Evaluation of all three gastrointestinal regions (stomach, small bowel, and colon), including exploratory observation, was feasible in 55 of 66 procedures, and small bowel lesions were identified in 28 procedures. In 6 of these (10.9%), lesions were confined exclusively to the small bowel, making them difficult to detect using conventional EGD and CS, and SBCE findings guided treatment decisions. In conclusion, SBCE can be safely performed in patients with gastrointestinal symptoms after allo-HCT and may provide unique diagnostic value, particularly in the evaluation of small bowel lesions.