Focused Review Series: Updates on Capsule Endoscopy from Esophagus to Colon
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Current Status of Interpretation of Small Bowel Capsule Endoscopy
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Su Hwan Kim, Dong-Hoon Yang, Jin Su Kim
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Clin Endosc 2018;51(4):329-333. Published online July 31, 2018
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DOI: https://doi.org/10.5946/ce.2018.095
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Abstract
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- Capsule endoscopy (CE) has revolutionized direct small bowel imaging and is widely used in clinical practice. Remote visualization ofbowel images enables painless, well-tolerated endoscopic examinations. Small bowel CE has a high diagnostic yield and the ability toexamine the entire small bowel. The diagnostic yield of CE relies on lesion detection and interpretation. In this review, issues related tolesion detection and interpretation of CE have been addressed, and the current status of automated reading software development hasbeen reviewed. Clinical significance of an external real-time image viewer has also been described.
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Tiago Lima Capela, Tiago Cúrdia Gonçalves, Bruno Rosa, José Cotter
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Focused Review Series: Current Issues and Future Directions of Small Bowel Endoscopic Evaluation
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The Usefulness of Capsule Endoscopy for Small Bowel Tumors
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Dae Young Cheung, Jin Su Kim, Ki-Nam Shim, Myung-Gyu Choi, Korean Gut Image Study Group
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Clin Endosc 2016;49(1):21-25. Published online January 28, 2016
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DOI: https://doi.org/10.5946/ce.2016.49.1.21
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Abstract
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- Video capsule endoscopy (VCE) has expanded the range of endoscopic examination of the small bowel. The clinical application of VCE is mainly for obscure gastrointestinal bleeding (OGIB) and small bowel tumor is one of the clinically significant diagnoses of VCE, often requiring subsequent invasive interventions. Small bowel tumors are detected with a frequency of around 4% with VCE in indications of OGIB, iron deficiency anemia, unexplained abdominal pain, and others. Protruding mass with bleeding, mucosal disruption, irregular surface, discolored area, and white villi are suggested as the VCE findings of small bowel tumor. Device assisted enteroscopy (DAE), computed tomography enteroclysis/enterography and magnetic resonance enteroclysis/enterography also have clinical value in small bowel examination and tumor detection, and they can be used with VCE, sequentially or complementarily. Familial adenomatous polyposis, Peutz-Jeghers syndrome, melanoma, lymphoma, and neuroendocrine tumor with hepatic metastasis are the high risk groups for small bowel tumors, and surveillance programs for small bowel tumors are needed. VCE and radiological imaging have value in screening, and in selected cases, DAE can provide more accurate diagnosis and endoscopic treatment. This review describes the usefulness and clinical impact of VCE on small bowel tumors.
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Original Article
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Indications for Detection, Completion, and Retention Rates of Small Bowel Capsule Endoscopy Based on the 10-Year Data from the Korean Capsule Endoscopy Registry
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Yun Jeong Lim, Oh Young Lee, Yoon Tae Jeen, Chi Yeon Lim, Dae Young Cheung, Jae Hee Cheon, Byong Duk Ye, Hyun Joo Song, Jin Su Kim, Jae Hyuk Do, Kwang Jae Lee, Ki-Nam Shim, Dong Kyung Chang, Cheol Hee Park, Byung Ik Jang, Jeong Seop Moon, Hoon Jai Chun, Myung-Gyu Choi, Jin Oh Kim, Korean Gut Image Study Group
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Clin Endosc 2015;48(5):399-404. Published online September 30, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.5.399
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Abstract
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- Background/Aims
Capsule endoscopy (CE) is widely used. However, CE has limitations including incomplete examination, inadequate bowel preparation, and retention. The aim of this study was to estimate the indications for and detection, completion, and retention rates of small intestine CE based on the 10-year data from the Korean Capsule Endoscopy Registry.
MethodsTwenty-four hospitals participated in this study. Clinical information, such as reasons for CE, method and quality of bowel preparation, and incomplete examination and capsule retention rates, was collected and analyzed.
ResultsA total of 2,914 CEs were registered. The most common reason for CE was obscure gastrointestinal bleeding (59%). Significant lesions were detected in 66% of cases. Positive CE diagnosis occurred in 63% of cases. The preparation method did not significantly affect the quality of bowel preparation for CE. The overall incomplete rate was 33%, and was high in the elderly and those with poor bowel preparation. Capsule retention was 3% and high in patients with small bowel tumors and Crohn's disease and in children under 10 years of age.
ConclusionsCE is a valuable technique; while the overall detection rate is high, incompletion and retention rates are also relatively high. CE should be carefully considered in the elderly and children less than 10 years of age, as well as in patients with small bowel tumors and Crohn's disease.
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Focused Review Series: Endoscopic Disinfection in the Era of MERS
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Clinical Practice Guidelines for Endoscope Reprocessing
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Hyun Jin Oh, Jin Su Kim
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Clin Endosc 2015;48(5):364-368. Published online September 30, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.5.364
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Abstract
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Gastrointestinal endoscopy is effective and safe for the screening, diagnosis, and treatment of gastrointestinal disease. However, issues regarding endoscope-transmitted infections are emerging. Many countries have established and continuously revise guidelines for endoscope reprocessing in order to prevent infections. While there are common processes used in endoscope reprocessing, differences exist among these guidelines. It is important that the reprocessing of gastrointestinal endoscopes be carried out in accordance with the recommendations for each step of the process.
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Original Article
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Performance and Clinical Role of Endoscopic Ultrasound Fine Needle Aspiration for Diagnosing Gastrointestinal Intramural Lesions
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Hea Jung Sung, Yu Kyung Cho, Eun Young Park, Sung Jin Moon, Chul Hyun Lim, Jin Su Kim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Myung-Gyu Choi, Kyu Yong Choi
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Clin Endosc 2013;46(6):627-632. Published online November 19, 2013
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DOI: https://doi.org/10.5946/ce.2013.46.6.627
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Abstract
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- Background/Aims
We evaluated the performance, clinical role, and diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in gastrointestinal intramural lesions.
MethodsProcedural and pathologic data were reviewed from consecutive patients undergoing EUS-FNA for intramural lesions. Final diagnoses were determined by surgical histopathologic conformation and the diagnosis of malignancy, including clinical follow-up with repeat imaging.
ResultsForty-six patients (mean age, 47 years; 24 males) underwent EUS-FNA. Lesions were located in the stomach (n=31), esophagus (n=5), and duodenum (n=10). The median lesion size was 2 cm (range, 1 to 20.6). Final diagnoses were obtained in 22 patients (48%). EUS-FNA was diagnostic in 40 patients (87%). The diagnostic accuracy of cytology for differentiating between benign and malignant lesions was 82%; diagnostic error occurred in three patients (6%). The cytologic results influenced clinical judgment in 78% cases. The primary reasons for negative or no clinical impact were false-negative results, misdirected patient management, and inconclusive cytology.
ConclusionsEUS-FNA exhibited an 87% diagnostic yield for gastrointestinal intramural lesions; the accuracy of cytology for differentiating malignancy was 82%. The limitations of EUS-FNA were primarily because of nondiagnostic sampling (9%) and probable diagnostic error (6%); these factors may influence the clinical role of EUS-FNA.
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Citations
Citations to this article as recorded by

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