Perez-Cuadrado-Robles E1, Lujan-Sanchis M2, Elli L3, Juanmartinena-Fernandez JF4, Garcıa-Lledo J5, Ruano-Dıaz L6, Egea-Valenzuela J7, Jimenez-Garcıa VA8, Arguelles-Arias F8, Juan-Acosta MS9, Carretero-Ribon C10, Alonso-Lazaro N11, Rosa B12, Sanchez-Ceballos F13, Lopez-Higueras A2, Fernandez-Urien-Sainz I4, Branchi F3, Valle-Muñoz J6, Borque-Barrera P9, Gonzalez-Vazquez S10, Pons-Beltran V11, Xavier S12, Gonzalez-Suarez B14, Herrerıas-Gutierrez JM8, Perez-Cuadrado-Martınez E2, Sempere-Garcıa-Arguelles J1; Enteroscopy and Capsule Endoscopy Spanish Society Group of the Spanish Society of Digestive Endoscopy (SEED).
1Small Bowel Unit, Morales Meseguer Hospital, Murcia, Spain.
2Digestive Diseases Unit, General University Hospital of Valencia, Valencia, Spain.
3Center for Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy.
4Gastroenterology and Endoscopy Unit, Navarra Hospital, Pamplona, Spain.
5Digestive Diseases Unit, General University Hospital Gregorio Marañon, Madrid, Spain.
6Department of Gastroenterology, Toledo Hospital, Toledo, Spain.
7Department of Gastroenterology, University Hospital Virgen de la Arrixaca, Murcia, Spain.
8Gastroenterology and Endoscopy Unit, University Hospital Virgen Macarena, Sevilla, Spain.
9Digestive Diseases Unit, University Hospital Nuestra Señora de Candelaria, Tenerife, Spain.
10Department of Gastroenterology, University of Navarra Clinic, Pamplona, Spain.
11Endoscopy Digestive Unit, Digestive Diseases Unit, University Hospital La Fe, Valencia, Spain.
12Digestive Diseases Unit, Senhora da Oliveira Hospital, Guimaraes, Portugal.
13Digestive Diseases Unit, San Carlos Hospital, Madrid, Spain.
14Endoscopy Digestive Unit Hospital Clinic of Barcelona, Barcelona, Spain.
Background and aim:
The role of capsule endoscopy (CE) in established celiac disease (CD) remains unclear. Our objective was to analyze the usefulness of CE in the suspicion of complicated CD.
This was a retrospective multicenter study. One hundred and eighty-nine celiac patients (mean age: 46.6 ± 16.6, 30.2% males) who underwent CE for alarm symptoms (n = 86, 45.5%) or non-responsive CD (n = 103, 54.5%) were included. Diagnostic yield (DY), therapeutic impact and safety were analyzed.
Capsule endoscopy was completed in 95.2% of patients (small bowel transit time: 270.5 ± 100.2 min). Global DY was 67.2%, detecting atrophic mucosa (n = 92, 48.7%), ulcerative jejunoileitis (n = 21, 11.1%), intestinal lymphoma (n = 7, 3.7%) and other enteropathies (n = 7, 3.7%, six Crohn's disease cases and one neuroendocrine tumor). The DY of CE was significantly higher in patients presenting with non-responsive disease compared to patients with alarm symptoms (73.8% vs 59.3%, P = 0.035). The new findings of the CE modified management in 59.3% of the cases. There were no major complications.
Capsule endoscopy may be a moderately helpful and safe diagnostic tool in the suspicion of complicated CD, modifying the clinical course of these patients.
© 2018 Japan Gastroenterological Endoscopy Society.