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The Study of Capsule Endoscopy Clinical Practice and Contrast Study with Other Diagnoses Methods for Small Intestinal Disease

Author: XuZhen
Tutor: XuJianMing
School: Anhui Medical University,
Course: Department of Gastroenterology,
Keywords: Capsule Endoscopy Small bowel disease Double balloon endoscopy Gastrointestinal bleeding Diagnosis Follow-up
CLC: R574.4
Type: Master's thesis
Year: 2010
Downloads: 41
Quote: 0
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Abstract


Background: The small intestine the lengthy detour overlap, away from the mouth and anus, imaging studies are difficult to diagnose and difficult parts. Capsule endoscopy and colonoscopy, the advent of the small intestine contrast CT, fill in the blank of the small intestine to the lack of visibility checks, a breakthrough in the diagnosis of diseases of the small intestine. However, due to capsule endoscopy has limitations, in the initial stage of clinical application at the same time, the urgent need to summarize the discipline preliminary clinical experience. In addition, domestic and capsule endoscopy (CE) and double balloon enteroscopy (DBE), small intestine contrast CT evaluation of clinical diagnostic value of small bowel disease vary. Summary of capsule endoscopy in clinical practice, the comparative study of capsule endoscopy and double-balloon enteroscopy or small bowel contrast CT clinical examination performance. Objective: To summarize the evaluation of capsule endoscopy diagnosis of intestinal diseases, especially intestinal bleeding value, comparative analysis of capsule endoscopy and enteroscopy or small bowel contrast CT clinical application value. PATIENTS AND METHODS: December 2007 to March 2010, continuous collection of 73 suspected small bowel disease patients, including 65 patients with obscure gastrointestinal bleeding. Capsule endoscopy in accordance with standard operating procedures, combined with clinical data to determine the reliability of its positive results. The grading standards proposed by the statistical analysis of subjects of general information on the type of bleeding, reference Costamagna determine the inspection results. Then inspection by history, medical records and telephone follow questionnaire method, unexplained gastrointestinal bleeding in patients with at least 3 months of follow-up. Follow-up including clinical indicators: re-examination, treatment, re-bleeding and blood transfusion; laboratory indicators: fecal occult blood and hemoglobin. The statistics capsule endoscopy positive group and positive group rebleeding rate, by univariate and multivariate data analysis to assess rebleeding factors for capsule endoscopy results again indicates that the risk of bleeding rate. Way of checking the suspected intestinal lesions were divided capsule endoscopy group, double-balloon enteroscopy group, small intestine contrast CT group, analysis of statistical three way of checking the detection of small bowel lesions and lesions of consistency. Results: (1) enrolled patients with suspected small bowel lesions 73 cases, 41 males and 32 females, mean age 55.1 ± 11.5 (18-82) years old. Capsule endoscopy completion rate of 98.5%, capsule gastric retention rate of 1.5%, the detection rate was 95.9% (70/73), the positive rate was 53.4% ??(39/73). In 65 patients with unexplained gastrointestinal bleeding patients, the detection rate was 95.4% (62/65), the positive rate was 57.0% (37/65). Clear causes of bleeding associated with disorders of the small intestine in the positive group, vascular abnormalities leading cause, followed by small intestinal stromal tumors. The follow-up found unexplained gastrointestinal bleeding capsule endoscopy positive group rebleeding rate was 41.6%, and 15.4% of non-positive group. In comparison, the difference was statistically significant. (P lt; 0.05) (2) capsule endoscopy and double-balloon enteroscopy Joint Inspection 11 cases, of which 81.8% detection rate of capsule endoscopy, the double balloon the small intestine microscopy was 54.5%; capsule endoscopy small bowel Check the completion rate, compared with enteroscopy, multi-segment high lesions. Capsule endoscopy and small intestine contrast CT Joint Inspection 6 cases, and 100% consistency between the two, including four cases of surgical treatment by surgery and pathological examination confirmed stromal tumors, consistent with the preoperative diagnosis. Conclusion: (1) capsule endoscopy unknown causes gastrointestinal bleeding, mostly found signs of intestinal lesions, but clinical positive only up to half of the positive results rebleeding risk lower rate. (2) double-balloon enteroscopy in the diagnosis of the cause of unexplained intestinal bleeding significantly better than capsule endoscopy, capsule endoscopy there is still some value in the small intestine, the multi-segment disease and long segment lesions, capsule endoscopy and small intestine contrast CT consistent rate, it is easy for patients to accept the security check.

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CLC: > Medicine, health > Internal Medicine > Digestive and abdominal diseases > Bowel disease > Gastro-intestinal disorders
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