1Gastroenterology and Endoscopy Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
2Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
Copyright © 2022 Korean Society of Gastrointestinal Endoscopy
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of Interest
The authors have no potential conflicts of interest.
Funding
None.
Acknowledgements
The authors are thankful to the members of the Center for Prevention and Diagnosis of Celiac Disease of Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico (Milan) for previous data storage.
Author Contributions
Conceptualization: LE, MF; Data curation: EC, SO; Formal analysis: EC, SO; Methodology: LE, AC, MF; Supervision: LE, MV, MF; Visualization: LE, AC, MF; Validation: LE, MV, MF; Writing–original draft: EC, AC; Writing–review & editing: all authors.
Variable | OGIB (n=35) | CeD (n=81) | Suspected/known IBD (n=43) | p-value |
---|---|---|---|---|
Capsule enteroscopy | ||||
Gastric transit time (min) | 35.1±50.3 | 24.8±39.7 | 26.6±29.4 | 0.44 |
Small-bowel transit time (min) | 239.9±93 | 308.7±102.5 | 276.9±116.8 | <0.01 |
Retentiona) | 0 | 2 | 0 | 0.23 |
Adequate bowel preparation | 33 (94.3) | 80 (98.8) | 42 (97.7) | 0.37 |
Lesion detection rate (%) | 62 | 55 | 51 | <0.05 |
Intestinal ultrasonography | ||||
Small-bowel dilatation | 1 (3) | 15 (18) | 10 (23) | <0.05 |
Increased wall thickness | 4 (11) | 7 (8) | 11 (25) | <0.05 |
Lymph nodes | 0 | 10 (12) | 6 (14) | <0.05 |
Mesenteric hypertrophy | 1 (3) | 3 (4) | 1 (2) | 0.91 |
Free abdominal fluid | 5 (14) | 10 (12) | 12 (28) | 0.08 |
Lesion detection rate (%) | 14 | 35 | 46 | <0.05 |
Values are presented as mean±standard deviation or number (%).
OGIB, obscure gastrointestinal bleeding; CeD, complicated celiac disease; IBD, inflammatory bowel disease.
a)In two patients capsule enteroscopy was retained due to the presence of stenosing lesions, requiring surgical intervention for removal.
Variable | OGIB (n=35) | CeD (n=81) | Suspected/known IBD (n=43) | Overall (n=159) |
---|---|---|---|---|
Female sex | 25 (71.4) | 62 (76.5) | 26 (60.5) | 113 (71.1) |
Body mass index (kg/m2) | 21.7±0.9 | 21.6±3.9 | 20.6±4.6 | 20.4±5.7 |
Age (yr) | 60.8±20.8 | 48.4±15.1 | 41.3±19.6 | 48.9±19.2 |
Autoimmune diseases | 3 (8.6) | 15 (18.5) | 3 (7.1) | 21 (13.2) |
Anticoagulant/antiplatelet therapy | 4 (11.4) | 2 (2.5) | 2 (4.7) | 8 (5.0) |
Cardiovascular diseases | 1 (2.9) | 3 (3.7) | 2 (4.7) | 6 (3.8) |
Variable | OGIB (n=35) | CeD (n=81) | Suspected/known IBD (n=43) | p-value |
---|---|---|---|---|
Capsule enteroscopy | ||||
Gastric transit time (min) | 35.1±50.3 | 24.8±39.7 | 26.6±29.4 | 0.44 |
Small-bowel transit time (min) | 239.9±93 | 308.7±102.5 | 276.9±116.8 | <0.01 |
Retention |
0 | 2 | 0 | 0.23 |
Adequate bowel preparation | 33 (94.3) | 80 (98.8) | 42 (97.7) | 0.37 |
Lesion detection rate (%) | 62 | 55 | 51 | <0.05 |
Intestinal ultrasonography | ||||
Small-bowel dilatation | 1 (3) | 15 (18) | 10 (23) | <0.05 |
Increased wall thickness | 4 (11) | 7 (8) | 11 (25) | <0.05 |
Lymph nodes | 0 | 10 (12) | 6 (14) | <0.05 |
Mesenteric hypertrophy | 1 (3) | 3 (4) | 1 (2) | 0.91 |
Free abdominal fluid | 5 (14) | 10 (12) | 12 (28) | 0.08 |
Lesion detection rate (%) | 14 | 35 | 46 | <0.05 |
Variable | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | LR (+) | LR (–) | Cohen's kappa coefficient |
---|---|---|---|---|---|---|---|
US overall | 45.9 (35.2–57.0) | 81.4 (70.3–89.7) | 75.4 (64.2–84.1) | 54.8 (49.2–60.3) | 2.5 (1.4–4.2) | 0.7 (0.5–0.8) | 0.26 (0.03–0.44) |
US OGIB | 14.3 (3.0–36.34) | 84.6 (54.5–98.1) | 82.1 (66.0–91.6) | 59.6 (51.3–67.4) | 0.9 (0.2–4.8) | 1.0 (0.7–1.3) | -0.01 (-0.20 to 0.19) |
US CeD | 52.3 (36.7–67.5) | 86.1 (70.5–95.3) | 82.1 (66.0–91.6) | 59.6 (51.3–67.4) | 3.8 (1.6–8.9) | 0.5 (0.4–0.8) | 0.37 (0.18–0.55) |
US suspected/known IBD | 63.6 (40.6–82.8) | 71.4 (47.8–88.7) | 70.0 (52.5–83.1) | 65.2 (50.3–77.6) | 2.2 (1.1–4.7) | 0.5 (0.3–0.9) | 0.35 (0.07–0.63) |
Values are presented as number (%) or mean±standard deviation. OGIB, obscure gastrointestinal bleeding; CeD, complicated celiac disease; IBD, inflammatory bowel disease.
Values are presented as mean±standard deviation or number (%). OGIB, obscure gastrointestinal bleeding; CeD, complicated celiac disease; IBD, inflammatory bowel disease. In two patients capsule enteroscopy was retained due to the presence of stenosing lesions, requiring surgical intervention for removal.
Values are presented as number (95% confidence interval). PPV, positive predictive value; NPV, negative predictive value; LR, likelihood ratio; US, ultrasonography; OGIB, obscure gastrointestinal bleeding; CeD, complicated celiac disease; IBD, inflammatory bowel disease.