Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2014
A pilot study of capsule endoscopy after a standard meal for the detection and grading of oesophageal varices in cirrhotic patients.
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Annicchiarico Brigida Eleonora, Riccioni Maria Elena, Siciliano Massimo, Urgesi Riccardo, Spada Cristiano, Caracciolo Gianluigi, Gasbarrini Antonio, Costamagna Guido
Аннотация
BACKGROUND: Capsule endoscopy has been proposed as an alternative to fibreoptic endoscopy for oesophageal varices evaluation in cirrhotics. However, it shows only moderate sensitivity compared to fibreoptic endoscopy.
AIM: To compare post-meal capsule endoscopy to fibreoptic endoscopy, based on the hypothesis that meal-induced increase of portal pressure can enhance its sensitivity.
METHODS: Twenty-five patients were submitted to fibreoptic endoscopy and, after a standard meal, capsule endoscopy.
RESULTS: Post-meal capsule endoscopy detected varices in the 18 patients in whom fibreoptic endoscopy detected varices plus 3 more subjects (sensitivity 100%, specificity 70%); large varices in the 4 patients in whom fibreoptic endoscopy graded varices as large, plus 5 more subjects; red markers in the 5 patients in whom fibreoptic endoscopy detected red markers, plus 3 more subjects. High-risk varices were identified in 11 patients by post-meal capsule endoscopy and in 10 by fibreoptic endoscopy (sensitivity 100%, specificity 93.8%).
CONCLUSIONS: Post-meal capsule endoscopy identified more varices, large varices and red markers than fibreoptic endoscopy. The two methods detected similar proportions of high-risk varices. These data suggest that a standard meal can enhance the sensitivity of capsule endoscopy in the detection and grading of oesophageal varices in cirrhotics.
AIM: To compare post-meal capsule endoscopy to fibreoptic endoscopy, based on the hypothesis that meal-induced increase of portal pressure can enhance its sensitivity.
METHODS: Twenty-five patients were submitted to fibreoptic endoscopy and, after a standard meal, capsule endoscopy.
RESULTS: Post-meal capsule endoscopy detected varices in the 18 patients in whom fibreoptic endoscopy detected varices plus 3 more subjects (sensitivity 100%, specificity 70%); large varices in the 4 patients in whom fibreoptic endoscopy graded varices as large, plus 5 more subjects; red markers in the 5 patients in whom fibreoptic endoscopy detected red markers, plus 3 more subjects. High-risk varices were identified in 11 patients by post-meal capsule endoscopy and in 10 by fibreoptic endoscopy (sensitivity 100%, specificity 93.8%).
CONCLUSIONS: Post-meal capsule endoscopy identified more varices, large varices and red markers than fibreoptic endoscopy. The two methods detected similar proportions of high-risk varices. These data suggest that a standard meal can enhance the sensitivity of capsule endoscopy in the detection and grading of oesophageal varices in cirrhotics.
Предметные рубрики MeSH
AdultAgedAged, 80 and overCapsule EndoscopyEsophageal and Gastric VaricesEsophagoscopyFemaleFiber Optic TechnologyHumansHypertension, PortalItalyLiver CirrhosisMaleMealsMiddle AgedPilot ProjectsPostprandial PeriodPredictive Value of TestsRisk AssessmentSampling StudiesSensitivity and SpecificitySeverity of Illness Index