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Editorial
Do all antithrombotic agents have a similar impact on small bowel bleeding?
Chung Hyun Tae, Ki-Nam Shim
Clin Endosc 2025;58(1):80-81.   Published online January 24, 2025
DOI: https://doi.org/10.5946/ce.2024.313
PDFPubReaderePub
  • 328 View
  • 19 Download
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Reviews
International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee, The Korean Society of Gastrointestinal Endoscopy Task Force on Clinical Practice Guidelines
Clin Endosc 2024;57(2):141-157.   Published online March 14, 2024
DOI: https://doi.org/10.5946/ce.2024.002
AbstractAbstract PDFPubReaderePub
Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

Citations

Citations to this article as recorded by  
  • EUS-guided gallbladder drainage for patients with antithrombotic therapy: Intervention or medication?
    Liqi Sun, Jiang Liu
    Gastrointestinal Endoscopy.2025; 101(1): 226.     CrossRef
  • Do all antithrombotic agents have a similar impact on small bowel bleeding?
    Chung Hyun Tae, Ki-Nam Shim
    Clinical Endoscopy.2025; 58(1): 80.     CrossRef
  • Prediction of immediate bleeding after cold snare polypectomy: A prospective observational study
    Shin Ju Oh, Yunho Jung, Young Hwangbo, Young Sin Cho, Il Kwun Chung, Chang Kyun Lee
    Medicine.2024; 103(36): e39597.     CrossRef
  • 7,828 View
  • 473 Download
  • 2 Web of Science
  • 3 Crossref
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Clinical practice guidelines for percutaneous endoscopic gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy Task Force on Clinical Practice Guidelines
Clin Endosc 2023;56(4):391-408.   Published online June 23, 2023
DOI: https://doi.org/10.5946/ce.2023.062
AbstractAbstract PDFSupplementary MaterialPubReaderePub
With an aging population, the number of patients with difficulty in swallowing due to medical conditions is gradually increasing. In such cases, enteral nutrition is administered through a temporary nasogastric tube. However, the long-term use of a nasogastric tube leads to various complications and a decreased quality of life. Percutaneous endoscopic gastrostomy (PEG) is the percutaneous placement of a tube into the stomach that is aided endoscopically and may be an alternative to a nasogastric tube when enteral nutritional is required for four weeks or more. This paper is the first Korean clinical guideline for PEG developed jointly by the Korean College of Helicobacter and Upper Gastrointestinal Research and led by the Korean Society of Gastrointestinal Endoscopy. These guidelines aimed to provide physicians, including endoscopists, with the indications, use of prophylactic antibiotics, timing of enteric nutrition, tube placement methods, complications, replacement, and tube removal for PEG based on the currently available clinical evidence.

Citations

Citations to this article as recorded by  
  • A systematic review and quality appraisal of guidelines and recommendations for home enteral tube feeding in adults
    Andriana Korai, Isabella Thomson, Sharon Carey, Margaret Allman-Farinelli
    European Journal of Clinical Nutrition.2025; 79(2): 104.     CrossRef
  • One-Year Mortality After Percutaneous Endoscopic Gastrostomy: The Prognostic Role of Nutritional Biomarkers and Care Settings
    Nermin Mutlu Bilgiç, Güldan Kahveci, Ekmel Burak Özşenel, Sema Basat
    Nutrients.2025; 17(5): 904.     CrossRef
  • A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
    Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
    Gut and Liver.2024; 18(1): 77.     CrossRef
  • Fast-track discharge following percutaneous endoscopic gastrostomy removal in head and neck cancer patients after remission: a feasibility and safety study
    Daniel Conceição, Luís Correia Gomes, Fátima Francisco, Ivone Frade, Joana Gramacho, Sandra Faias, Isabel Claro
    Journal of Gastrointestinal Surgery.2024; 28(6): 943.     CrossRef
  • When to feed after percutaneous endoscopic gastrostomy: A systematic review and meta‐analysis of randomized controlled trials
    Matthew L. Bechtold, Zahid Ijaz Tarar, Muhammad N. Yousaf, Ghady Moafa, Abdul M. Majzoub, Xheni Deda, Michelle L. Matteson‐Kome, Srinivas R. Puli
    Nutrition in Clinical Practice.2024; 39(5): 1191.     CrossRef
  • The Effect of Oral Diet Training in Indwelling Nasogastric Tube Patients with Prolonged Dysphagia
    Byung-chan Choi, Sook Joung Lee, Eunseok Choi, Sangjee Lee, Jungsoo Lee
    Nutrients.2024; 16(15): 2424.     CrossRef
  • The Impact of Palliative Decompressive Gastrostomy Tube Placement on Patients and Their Caregivers: A Mixed Methods Analysis
    Jeffrey L. Roberson, Julia A. Gasior, Sara P. Ginzberg, Emna Bakillah, Jesse Passman, Lauren Shreve, Catherine E. Sharoky, Gregory Nadolski, Katherine R. Courtright, Elinore J. Kaufman
    Annals of Surgical Oncology.2024; 31(10): 6931.     CrossRef
  • 7,390 View
  • 567 Download
  • 7 Web of Science
  • 7 Crossref
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Original Articles
Positive Fecal Occult Blood Test is a Predictive Factor for Gastrointestinal Bleeding after Capsule Endoscopy in Patients with Unexplained Iron Deficiency Anemia: A Korean Multicenter CAPENTRY Study
Ji Young Chang, Chang Mo Moon, Ki-Nam Shim, Dae Young Cheung, Hyun Seok Lee, Yun Jeong Lim, Seong Ran Jeon, Soo Jung Park, Kyeong Ok Kim, Hyun Joo Song, Hyun Joo Jang, Ji Hyun Kim
Clin Endosc 2020;53(6):719-726.   Published online November 6, 2020
DOI: https://doi.org/10.5946/ce.2019.149
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Capsule endoscopy (CE) is recommended as the primary method for the evaluation of unexplained anemia. This study aimed to assess the diagnostic yield of CE in patients with unexplained iron deficiency anemia (IDA) without overt bleeding, and to evaluate their long-term outcomes and related clinical factors.
Methods
Data of patients who underwent CE for the evaluation of IDA were reviewed from a CE registry in Korea. Additional clinical data were collected by the involved investigators of each hospital through a review of medical records.
Results
Among a total of 144 patients, the diagnostic yield of CE was 34%. Gastrointestinal (GI) bleeding was found in 6.3% (n=9) of the patients (occult bleeding in four patients and overt bleeding in five patients) during a mean follow-up of 17.8 months. Patients with a positive fecal occult blood test (FOBT) result at the initial diagnosis had a higher rate of GI bleeding after CE (p=0.004). In addition, a positive FOBT result was the only independent predictive factor for GI bleeding (hazard ratio, 5.30; 95% confidence interval, 1.41–19.85; p=0.013).
Conclusions
Positive FOBT is a predictive factor for GI bleeding during follow-up after CE in patients with unexplained IDA without overt bleeding. Thus, patients with positive FOBT need to be more closely followed up.

Citations

Citations to this article as recorded by  
  • Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022
    Marco Pennazio, Emanuele Rondonotti, Edward J. Despott, Xavier Dray, Martin Keuchel, Tom Moreels, David S. Sanders, Cristiano Spada, Cristina Carretero, Pablo Cortegoso Valdivia, Luca Elli, Lorenzo Fuccio, Begona Gonzalez Suarez, Anastasios Koulaouzidis,
    Endoscopy.2023; 55(01): 58.     CrossRef
  • Predictive Model for Positive Video Capsule Endoscopy in Iron Deficiency Anemia
    Shadi Hamdeh, Jihan Fathallah, Hui Zhang, Amber Charoen, Barakat Aburajab Altamimi, Florence-Damilola Odufalu, Devashree Dave, Amer El Sayed, Laura R. Glick, Scott Grisolano, Christine Hachem, Muhammad Bader Hammami, Khaldoun Haj Mahmoud, Alexander N. Lev
    Digestive Diseases and Sciences.2023; 68(7): 3083.     CrossRef
  • Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis
    Wonshik Kim, Beomjae Lee, Ahyoung Yoo, Seunghan Kim, Moonkyung Joo, Jong-Jae Park
    Diagnostics.2021; 11(11): 2123.     CrossRef
  • 6,779 View
  • 136 Download
  • 4 Web of Science
  • 3 Crossref
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Comparison of the Diagnostic Ability of Endoscopic Ultrasonography and Abdominopelvic Computed Tomography in the Diagnosis of Gastric Subepithelial Tumors
Sang Yoon Kim, Ki-Nam Shim, Joo-Ho Lee, Ji Young Lim, Tae Oh Kim, A. Reum Choe, Chung Hyun Tae, Hye-Kyung Jung, Chang Mo Moon, Seong-Eun Kim, Sung-Ae Jung
Clin Endosc 2019;52(6):565-573.   Published online July 17, 2019
DOI: https://doi.org/10.5946/ce.2019.019
AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic ultrasonography (EUS) is the most efficient imaging modality for gastric subepithelial tumors (SETs). However, abdominopelvic computed tomography (APCT) has other advantages in evaluating the characteristics, local extension, or invasion of SETs to adjacent organs. This study aimed to compare the diagnostic ability of EUS and APCT based on surgical histopathology results.
Methods
We retrospectively reviewed data from 53 patients who underwent both EUS and APCT before laparoscopic wedge resection for gastric SETs from January 2010 to December 2017 at a single institution. On the basis of histopathology results, we assessed the diagnostic ability of the 2 tests.
Results
The overall accuracy of EUS and APCT was 64.2% and 50.9%, respectively. In particular, the accuracy of EUS vs. APCT for the diagnosis of gastrointestinal stromal tumors (GISTs), leiomyomas, and ectopic pancreas was 83.9% vs. 74.2%, 37.5% vs. 0.0%, and 57.1% vs. 14.3%, respectively. Most of the incorrect diagnoses with EUS involved hypoechoic lesions originating in the fourth echolayer, with the most common misdiagnosed lesions being GISTs mistaken for leiomyomas and vice versa.
Conclusions
APCT showed a lower overall accuracy than EUS; however, APCT remains a useful modality for malignant/potentially malignant gastric SETs.

Citations

Citations to this article as recorded by  
  • Correlation of preoperative CT features with intra- and postoperative parameters of endoscopic resection in patients with gastric submucosal tumor (1~3 cm)
    Yuxiang Chen, Mo Chen, Zhu Wang, Junchao Wu, Jinlin Yang, Li Yang, Kai Deng
    Surgical Endoscopy.2025; 39(1): 259.     CrossRef
  • Endoscopic calabash technique for gastric mesenchymal tumours: A low hanging fruit or a novel endoscopic technique?
    David Rea, Caroline Tham, Tony CK Tham
    World Journal of Gastrointestinal Endoscopy.2025;[Epub]     CrossRef
  • Guidelines in Practice: The Diagnosis and Management of Gastrointestinal Subepithelial Lesions
    Brian C. Jacobson, Vanessa M. Shami
    American Journal of Gastroenterology.2024; 119(3): 397.     CrossRef
  • Advances in Endoscopic Diagnosis and Treatment of Gastric Neuroendocrine Neoplasms
    Xinrui Guo, Xiaohan Zhao, Gang Huang, Yanbo Yu
    Digestive Diseases and Sciences.2024; 69(1): 27.     CrossRef
  • Diagnostic Endoscopic Ultrasound (EUS) of the Luminal Gastrointestinal Tract
    Giovanna Impellizzeri, Giulio Donato, Claudio De Angelis, Nico Pagano
    Diagnostics.2024; 14(10): 996.     CrossRef
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    Zachary Lee, Divya Mohanraj, Abraham Sachs, Madhavi Kambam, Sandra DiBrito
    International Journal of Translational Medicine.2024; 4(3): 387.     CrossRef
  • Efficacy of EUS-guided keyhole biopsies in diagnosing subepithelial lesions of the upper gastrointestinal tract
    Sen Verhoeve, Cynthia Verloop, Marco Bruno, Valeska Terpstra, Lydi Van Driel, Lars Perk, Lieke Hol
    Endoscopy International Open.2024; 12(10): E1183.     CrossRef
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    Marzia Varanese, Marco Spadaccini, Antonio Facciorusso, Gianluca Franchellucci, Matteo Colombo, Marta Andreozzi, Daryl Ramai, Davide Massimi, Roberto De Sire, Ludovico Alfarone, Antonio Capogreco, Roberta Maselli, Cesare Hassan, Alessandro Fugazza, Alessa
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    Ricardo Rangel de Paula PESSOA, Alexandre Moraes BESTETTI, Victor Lira de OLIVEIRA, Wladimir Campos de ARAUJO, Simone GUARALDI, Rodrigo Roda RODRIGUES SILVA, Francisco Antonio Araujo OLIVEIRA, Maria Sylvia Ierardi RIBEIRO, Fred Olavo Aragão Andrade CARNEI
    Arquivos de Gastroenterologia.2024;[Epub]     CrossRef
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    Jaewoo Kim, Dasom Heo, Seonghee Cho, Mingyu Ha, Jeongwoo Park, Joongho Ahn, Minsu Kim, Donggyu Kim, Da Hyun Jung, Hyung Ham Kim, Hee Man Kim, Chulhong Kim
    Science Advances.2024;[Epub]     CrossRef
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    Jiali Wu, Mengqi Zhuang, Yubao Zhou, Xiang Zhan, Weiwei Xie
    Scandinavian Journal of Gastroenterology.2023; 58(5): 542.     CrossRef
  • ACG Clinical Guideline: Diagnosis and Management of Gastrointestinal Subepithelial Lesions
    Brian C. Jacobson, Amit Bhatt, Katarina B. Greer, Linda S. Lee, Walter G. Park, Bryan G. Sauer, Vanessa M. Shami
    American Journal of Gastroenterology.2023; 118(1): 46.     CrossRef
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    Moon Won Lee, Bong Eun Lee
    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2023; 23(1): 28.     CrossRef
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    Gwang Ha Kim
    Gut and Liver.2022; 16(1): 19.     CrossRef
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    Pierre H. Deprez, Leon M.G. Moons, Dermot OʼToole, Rodica Gincul, Andrada Seicean, Pedro Pimentel-Nunes, Gloria Fernández-Esparrach, Marcin Polkowski, Michael Vieth, Ivan Borbath, Tom G. Moreels, Els Nieveen van Dijkum, Jean-Yves Blay, Jeanin E. van Hooft
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    V. O. Shaprynskyi, Yu. V. Babii
    Kharkiv Surgical School.2022; (4-5): 46.     CrossRef
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    Diagnostics.2021; 11(11): 2160.     CrossRef
  • Ultrasonido endoscópico, aplicaciones actuales en tumores sólidos gastrointestinales
    Gabriel Alonso Mosquera-Klinger, Jhon Jaime Carvajal Gutiérrez, Alavaro Andrés Gómez Venegas, Sebastián Niño Ramírez, Raúl Cañadas Garrido
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    Eun Young Park, Gwang Ha Kim
    Clinical Endoscopy.2019; 52(6): 519.     CrossRef
  • 7,423 View
  • 203 Download
  • 20 Web of Science
  • 25 Crossref
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Review
Quality Indicators for Small Bowel Capsule Endoscopy
Ki-Nam Shim, Seong Ran Jeon, Hyun Joo Jang, Jinsu Kim, Yun Jeong Lim, Kyeong Ok Kim, Hyun Joo Song, Hyun Seok Lee, Jae Jun Park, Ji Hyun Kim, Jaeyoung Chun, Soo Jung Park, Dong-Hoon Yang, Yang Won Min, Bora Keum, Bo-In Lee, Korean Gut Image Study Group
Clin Endosc 2017;50(2):148-160.   Published online March 30, 2017
DOI: https://doi.org/10.5946/ce.2017.030
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Capsule endoscopy (CE) enables evaluation of the entire mucosal surface of the small bowel (SB), which is one of the most important steps for evaluating obscure gastrointestinal bleeding. Although the diagnostic yield of SB CE depends on many clinical factors, there are no reports on quality indicators. Thus, the Korean Gut Image Study Group (KGISG) publishes an article titled, “Quality Indicators for Small Bowel Capsule Endoscopy” under approval from the Korean Society of Gastrointestinal Endoscopy (KSGE). Herein, we initially identified process quality indicators, while the structural and outcome indicators are reserved until sufficient clinical data are accumulated. We believe that outcomes of SB CE can be improved by trying to meet our proposed quality indicators.

Citations

Citations to this article as recorded by  
  • Artificial Intelligence-assisted Analysis of Pan-enteric Capsule Endoscopy in Patients with Suspected Crohn’s Disease: A Study on Diagnostic Performance
    Jacob Broder Brodersen, Michael Dam Jensen, Romain Leenhardt, Jens Kjeldsen, Aymeric Histace, Torben Knudsen, Xavier Dray
    Journal of Crohn's and Colitis.2024; 18(1): 75.     CrossRef
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    Gut and Liver.2024; 18(4): 686.     CrossRef
  • Deep Learning-Based Real-Time Organ Localization and Transit Time Estimation in Wireless Capsule Endoscopy
    Seung-Joo Nam, Gwiseong Moon, Jung-Hwan Park, Yoon Kim, Yun Jeong Lim, Hyun-Soo Choi
    Biomedicines.2024; 12(8): 1704.     CrossRef
  • Risk factors of delayed upper gastrointestinal transit in capsule endoscopy
    Xin Long He, Hui Min Chen, Han Bing Xue
    Scandinavian Journal of Gastroenterology.2024; 59(10): 1216.     CrossRef
  • Procedimiento, lectura e interpretación de cápsula endoscópica
    Valeria Atenea Costa, Begoña González-Suárez, Maria Teresa Galiano
    Revista de Gastroenterología del Perú.2024; 44(3): 273.     CrossRef
  • Use of Device-Assisted Enteroscopy in Small Bowel Disease: An Expert Consensus Statement by the Korean Association for the Study of Intestinal Diseases
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    The Korean Journal of Gastroenterology.2023; 81(1): 1.     CrossRef
  • Small Bowel Capsule Endoscopy within 6 Hours Following Bowel Preparation with Polyethylene Glycol Shows Improved Small Bowel Visibility
    Chang Wan Choi, So Jung Lee, Sung Noh Hong, Eun Ran Kim, Dong Kyung Chang, Young-Ho Kim, Yun Jeong Lim, Ki-Nam Shim, Hyun-Seok Lee
    Diagnostics.2023; 13(3): 469.     CrossRef
  • Use of device-assisted enteroscopy in small bowel disease: an expert consensus statement by the Korean Association for the Study of Intestinal Diseases
    Han Hee Lee, Jin Su Kim, Hyeon Jeong Goong, Shin Hee Lee, Eun Hye Oh, Jihye Park, Min Cheol Kim, Kwangwoo Nam, Young Joo Yang, Tae Jun Kim, Seung-Joo Nam, Hee Seok Moon, Jae Hyun Kim, Duk Hwan Kim, Seong-Eun Kim, Seong Ran Jeon, Seung-Jae Myung
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  • Design of a Convolutional Neural Network as a Deep Learning Tool for the Automatic Classification of Small-Bowel Cleansing in Capsule Endoscopy
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    Journal of Clinical Medicine.2023; 12(23): 7328.     CrossRef
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    A. A. Likutov, T. A. Vlasko, V. V. Veselov
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    Jonathan A. Leighton, Andrew S. Brock, Carol E. Semrad, David J. Hass, Nalini M. Guda, Jodie A. Barkin, Glenn M. Eisen
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    Gastrointestinal Endoscopy.2022; 96(5): 693.     CrossRef
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    DE Yung, AR Robertson, M Davie, R Sidhu, M McAlindon, I Rahman, P Patel, L Sinha, S Mason, J Brzeszczynska, S Douglas, JN Plevris, A Koulaouzidis
    Digestive and Liver Disease.2021; 53(4): 461.     CrossRef
  • Clinical Outcomes between P1 and P0 Lesions for Obscure Gastrointestinal Bleeding with Negative Computed Tomography and Capsule Endoscopy
    Young Kyu Cho, Heesu Park, Jung Rock Moon, Seong Ran Jeon, Hyun Gun Kim, Tae Hee Lee, Junseok Park, Jin-Oh Kim, Joon Seong Lee, Hyeon Jeong Goong, Bong Min Ko, Suyeon Park
    Diagnostics.2021; 11(4): 657.     CrossRef
  • Improved Capsule Endoscopy Using New Computer Vision Technologies
    Junseok Park
    The Korean Journal of Medicine.2021; 96(3): 190.     CrossRef
  • Double-balloon enteroscopy for retrieving retained small-bowel video capsule endoscopes: a systematic review
    Ye Gao, Lei Xin, Yu-Xin Wang, Yuan-Hang Dong, Zhuan Liao, Zhao-Shen Li, Yi-Qi Du
    Scandinavian Journal of Gastroenterology.2020; 55(1): 105.     CrossRef
  • Capsule endoscopy in inflammatory bowel disease: when and how
    Ida Hilmi, Taku Kobayashi
    Intestinal Research.2020; 18(3): 265.     CrossRef
  • Use of small bowel capsule endoscopy in clinical practice: how has it performed?
    Seong Ran Jeon
    The Korean Journal of Internal Medicine.2020; 35(4): 854.     CrossRef
  • Adherence to European Society of Gastrointestinal Endoscopy recommendations of endoscopists performing small bowel capsule endoscopy in Italy
    Emanuele Rondonotti, Cristiano Spada, Marco Pennazio, Roberto de Franchis, Sergio Cadoni, Carlo Girelli, Cesare Hassan, Riccardo Marmo, Maria Elena Riccioni, Giuseppe Scarpulla, Marco Soncini, Maurizio Vecchi, Renato Cannizzaro
    Digestive and Liver Disease.2019; 51(6): 818.     CrossRef
  • CapsoCam SV-1 Versus PillCam SB 3 in the Detection of Obscure Gastrointestinal Bleeding
    Lilli L. Zwinger, Britta Siegmund, Andrea Stroux, Andreas Adler, Winfried Veltzke-Schlieker, Robert Wentrup, Christian Jürgensen, Bertram Wiedenmann, Felix Wiedbrauck, Stephan Hollerbach, Thomas Liceni, Christian Bojarski
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  • Outcomes and Management Strategies for Capsule Retention: A Korean Capsule Endoscopy Nationwide Database Registry Study
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Focused Review Series: Current Issues and Future Directions of Small Bowel Endoscopic Evaluation
The Usefulness of Capsule Endoscopy for Small Bowel Tumors
Dae Young Cheung, Jin Su Kim, Ki-Nam Shim, Myung-Gyu Choi, Korean Gut Image Study Group
Clin Endosc 2016;49(1):21-25.   Published online January 28, 2016
DOI: https://doi.org/10.5946/ce.2016.49.1.21
AbstractAbstract PDFPubReaderePub
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
Indications for Detection, Completion, and Retention Rates of Small Bowel Capsule Endoscopy Based on the 10-Year Data from the Korean Capsule Endoscopy Registry
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
Clin Endosc 2015;48(5):399-404.   Published online September 30, 2015
DOI: https://doi.org/10.5946/ce.2015.48.5.399
AbstractAbstract PDFPubReaderePub
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.

Methods

Twenty-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.

Results

A 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.

Conclusions

CE 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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Commentary
What Is the Optimal Timing of Bowel Preparation for Video Capsule Endoscopy?
Hyun Joo Song, Ki-Nam Shim
Clin Endosc 2015;48(3):183-184.   Published online May 29, 2015
DOI: https://doi.org/10.5946/ce.2015.48.3.183
PDFPubReaderePub

Citations

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Original Article
Comparison between the Effectiveness of Oral Phloroglucin and Cimetropium Bromide as Premedication for Diagnostic Esophagogastroduodenoscopy: An Open-Label, Randomized, Comparative Study
Hye-Won Yun, Ki-Nam Shim, Sun-Kyung Na, Jae-In Ryu, Min-Jin Lee, Eun-Mi Song, Seong-Eun Kim, Hye-Kyoung Jung, Sung-Ae Jung
Clin Endosc 2015;48(1):48-51.   Published online January 31, 2015
DOI: https://doi.org/10.5946/ce.2015.48.1.48
AbstractAbstract PDFPubReaderePub
Background/Aims

Suppression of gastrointestinal (GI) peristalsis during GI endoscopy commonly requires antispasmodic agents such as hyoscine butylbromide, atropine, glucagon, and cimetropium bromide. This study examined the efficacy of oral phloroglucin for the suppression of peristalsis, its impact on patient compliance, and any associated complications, and compared it with intravenous or intramuscular cimetropium bromide administration.

Methods

This was a randomized, investigator-blind, prospective comparative study. A total of 172 patients were randomized into two groups according to the following medications administered prior to upper endoscopy: oral phloroglucin (group A, n=86), and cimetropium bromide (group B, n=86). The numbers and the degrees of peristalsis events at the antrum and second duodenal portion were assessed for 30 seconds.

Results

A significantly higher number of gastric peristalsis events was observed in group A (0.49 vs. 0.08, p<0.001), but the difference was not clinically significant. No significant difference between both groups was found in the occurrence of duodenal peristalsis events (1.79 vs. 1.63, p=0.569). The incidence of dry mouth was significantly higher with cimetropium bromide than with phloroglucin (50% vs. 15.1%, p<0.001).

Conclusions

Oral phloroglucin can be used as an antispasmodic agent during upper endoscopy, and shows antispasmodic efficacy and adverse effects similar to those of cimetropium bromide.

Citations

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Reviews
Should Capsule Endoscopy Be the First Test for Every Obscure Gastrointestinal Bleeding?
Chung Hyun Tae, Ki-Nam Shim
Clin Endosc 2014;47(5):409-414.   Published online September 30, 2014
DOI: https://doi.org/10.5946/ce.2014.47.5.409
AbstractAbstract PDFPubReaderePub

Obscure gastrointestinal bleeding (OGIB) refers to gastrointestinal (GI) bleeding of unclear origin that persists or recurs after negative findings on esophagogastroduodenoscopy and colonoscopy. OGIB accounts for approximately 5% of all types of GI bleeding. More than 80% of OGIB cases originate in the small bowel. The ability to detect OGIB in the small bowel has significantly advanced and been revolutionized since the introduction of the capsule endoscopy and double-balloon enteroscopy techniques in 2000 and 2001, respectively. With these new methods for small-bowel evaluation, new guidelines have been proposed for the diagnosis and management of OGIB. However, some issues remain unsolved. The purpose of this article is to review the various modalities used for evaluating OGIB, including capsule endoscopy and double-balloon enteroscopy, and to help guide clinicians in their decisions on which modality will be the most effective.

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Guideline for Capsule Endoscopy: Obscure Gastrointestinal Bleeding
Ki-Nam Shim, Jeong Seop Moon, Dong Kyung Chang, Jae Hyuk Do, Ji Hyun Kim, Byung Hoon Min, Seong Ran Jeon, Jin-Oh Kim, Myung-Gyu Choi, Korean Gut Image Study Group
Clin Endosc 2013;46(1):45-53.   Published online January 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.1.45
AbstractAbstract PDFPubReaderePub

Capsule endoscopy (CE) is considered as a noninvasive and reliable diagnostic tool of examining the entire small bowel. CE has been performed frequently at many medical centers in South Korea; however, there is no evidence-based CE guideline for adequate diagnostic approaches. To provide accurate information and suggest correct testing approaches for small bowel disease, the guideline on CE was developed by the Korean Gut Image Study Group, a part of the Korean Society of Gastrointestinal Endoscopy. Operation teams for developing the guideline were organized into four areas: obscure gastrointestinal bleeding, small bowel preparation, Crohn's disease, and small bowel tumor. A total of 20 key questions were selected. In preparing this guideline, MEDLINE, Cochrane library, KMbase, KISS, and KoreaMed literature searches were performed. After writing a draft of the guideline, opinions from various experts were reflected before approving the final document. The guideline should be regarded as recommendations only to gastroenterologists in providing care to their patients. These are not absolute rules and should not be construed as establishing a legal standard of care. Although further revision may be necessary as new data appear, this guideline is expected to play a role for adequate diagnostic approaches of various small bowel diseases.

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Original Article
The Clinical Meaning of Benign Colon Uptake in 18F-FDG PET: Comparison with Colonoscopic Findings
Sun Hee Roh, Sung-Ae Jung, Seong-Eun Kim, Hye-In Kim, Min Jin Lee, Chung Hyun Tae, Ju Young Choi, Ki-Nam Shim, Hye-Kyung Jung, Tae Hun Kim, Kwon Yoo, Il Hwan Moon, Bom Sahn Kim
Clin Endosc 2012;45(2):145-150.   Published online June 30, 2012
DOI: https://doi.org/10.5946/ce.2012.45.2.145
AbstractAbstract PDFPubReaderePub
Background/Aims

Benign colon 18F-fluorodeoxyglucose (FDG) uptake is frequently observed in asymptomatic individuals. Aims of this study were to investigate the benign colon uptake by whole body FDG-positron emission tomography (PET) in asymptomatic adults and to correlate those results with colonoscopic and histologic findings.

Methods

Among 3,540 subjects who had undergone FDG-PET, 43 subjects who were diagnosed to have benign colon uptake in FDG-PET and underwent colonoscopy were retrospectively reviewed. Subjects were classified as diffuse or focal groups based on their FDG uptake patterns. PET results were analyzed together with colonoscopic and histologic findings.

Results

Forty-three subjects showed benign colon uptake in FDG-PET; 28 of them were shown as the diffuse group, while other 15 subjects were classified as the focal group. Five subjects among those showed diffuse uptake were diagnosed as adenoma. Seven among 15 subjects who showed focal uptake were diagnosed as adenocarcinoma (n=2), adenoma (n=3), or non-neoplastic polyp (n=2). Positive predictive values were 25% in the diffuse group and 47% in the focal group.

Conclusions

We recommend that patients showing benign FDG uptake in the colon should be further evaluated by colonoscopy, especially for patients with focal FDG uptake.

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