Is a 2-liter PEG preparation useful before capsule endoscopy?

AIMS: Small bowel contents can sometimes hamper the quality of capsule images. Our aim was to investigate the effect of PEG administered prior to capsule endoscopy (CE) upon quality of images, gastrointestinal transit time, and detection rate of small bowel bleeding lesions in patients with obscure gastrointestinal bleeding. PATIENTS AND METHODS: Forty-two consecutive patients were included. CE was performed following a 12-hour fasting period. The 16 first patients (Group A) received no preparation and the following 27 patients (Group B) received 2 L of PEG the night before. The quality of images was assessed at both in duodenojejunum and ileum level, using a scale including the presence of air bubbles, biliary secretion, and residue (1-4). RESULTS: Quality of images were not different in Group A compared with Group B in the duodenojejunum and in the ileum. Gastric transit time tended to be shorter in Group A compared with Group B (25.5 vs. 45.7 minutes) (P = 0.15), whereas small bowel transit was not different between both groups (271 vs. 288 minutes). Total small bowel CE examination was complete in Group A and in 24 of 26 in Group B (not significant). Potential bleeding lesions were seen in 8 patients in Group A and 12 in Group B (not significant). CONCLUSION: Our retrospective study suggests that 2 L PEG preparation seems able to improve neither the quality of CE images nor its diagnostic performance. Moreover, in our study, PEG tended to increase gastric emptying time and may constitute a limitation for small bowel complete examination.

Inflammatory pseudotumor of the liver revealing gynecological Corynebacterium infection.

Inflammatory pseudotumor (IPL) of the liver is a rare benign clinicopathologic entity, which has been associated with infectious conditions, including alimentary, digestive tract and mouth infections. We report a new case, where a patient developed hepatic IPL that revealed endometritis related to Corynebacterium infection; the patient had a favorable outcome of hepatic IPL after appropriate antibiotic therapy initiation. Our findings therefore confirm that antibiotic therapy may be effective in patients with hepatic IPL associated with underlying infections, avoiding unnecessary surgery. Our data also indicate that when hepatic IPL is observed, a complete clinical evaluation, including gynecological evaluation, should be systematically performed.