A prospective trial comparing wireless capsule endoscopy and barium contrast series for small-bowel surveillance in hereditary GI polyposis syndromes

• Published in: Gastrointestinal endoscopy 2005-05, Vol.61 (6), p.721-725
• Main Authors: Mata, Alfredo, Llach, Josep, Castells, Antoni, Rovira, Josep M., Pellisé, María, Ginès, Angels, Fernández-Esparrach, Gloria, Andreu, Montserrat, Bordas, Josep M., Piqué, Josep M.
• Format: Article
• Language: English
• Subjects: Administration, Rectal; Adult; Barium Sulfate - administration & dosage; Biological and medical sciences; Capsules; Contrast Media - administration & dosage; Dermatology; Digestive system. Abdomen; Endoscopy; Endoscopy, Gastrointestinal - methods; Enema - methods; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Intestine, Small - diagnostic imaging; Intestine, Small - pathology; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Peutz-Jeghers Syndrome - diagnosis; Pigmentary diseases of the skin; Prospective Studies; Radiography; Reproducibility of Results; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Telemetry; Tumors
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/S0016-5107(05)00289-0

Capsule endoscopy has demonstrated its clinical utility in the evaluation of the small bowel, and, accordingly, it has been suggested that it could be useful for the identification of small-intestinal polyps in patients with polyposis syndromes. The objective was to establish the effectiveness of wireless capsule endoscopy for detecting small-bowel polyps in patients with hereditary GI polyposis syndromes in comparison with barium contrast series. Consecutive patients with GI polyposis syndromes were included. Small-bowel follow-through series and capsule endoscopy were performed within 1 week, in a blind fashion. The number and the location of polyps were analyzed. Twenty-four patients with familial adenomatous polyposis (n = 20) or Peutz-Jeghers syndrome (n = 4) were included. Capsule endoscopy detected small-bowel polyps in 7 of 24 patients (29%), whereas a barium contrast study identified small-intestinal polyps in only 3 of these 7 patients. In the 4 remaining patients, all of them with familial adenomatous polyposis, polyps detected by the capsule but missed in radiographic series were located at either ileum (2 patients), jejunum (1), or duodenum (1). No procedure-related complication was observed in any patient. Wireless capsule endoscopy is a highly accurate technique for the detection of small-bowel polyps in patients with hereditary GI polyposis syndromes, and it represents a valuable alternative to barium contrast series in the surveillance of patients with Peutz-Jeghers syndrome