Capsule with microscopic camera provides better look

06.05.2003

A new capsule that contains a microscopic camera and transmitter can create better pictures of the small bowel than standard x-ray procedures can, a new study shows. The capsule is easily swallowed by the patient, and there is no need for the patient to drink barium before the procedure.

The study, conducted by Sandor Joffe, MD, section head of abdominal imaging, and his colleagues at Beth Israel Medical Center in New York, found that wireless capsule endoscopy was better able than a small bowel series to find the cause of the patient’s symptoms. The small bowel series consists of a series of x-rays of the abdomen after the patient drinks several cups of barium.

Twenty patients underwent both the wireless capsule endoscopy and the small bowel series, says Dr. Joffe. These patients had a variety of symptoms; many of them were being examined because they were anemic or blood had been detected in their stool.

The wireless capsule endoscopy was much better in finding vascular malformations as well as ulcerations or erosions in the bowel, all of which can cause bleeding, says Dr. Joffe.

"Significant findings, based on their ability to explain the patient’s symptoms were noted on the small bowel series in only two cases. That compares to 11 cases with the capsule endoscopy," says Dr. Joffe.

There are some downsides to the use of the capsule endoscopy, notes Dr. Joffe. The patient swallows the capsule, then must wear a data receiver for eight hours. The patient can walk, work or do whatever else he/she wants during this time as long as it isn’t very strenuous, says Dr. Joffe. Although the images are reviewed at high speed at a workstation, it is a time-consuming process for the gastroenterologist to view all the images from the examination.

In addition, patients with a small bowel obstruction or narrowing of the small bowel should not have a capsule endoscopy procedure because the capsule could get lodged in the bowel. These patients should have the small bowel series instead, Dr. Joffe says.

Dr. Joffe will present his study on May 6 during the ARRS Annual Meeting.

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