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1.
Rev Esp Enferm Dig ; 112(4): 309-318, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32188259

RESUMO

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small-bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication, and its diagnostic and therapeutic yield. A set of recommendations was issued accordingly.


Assuntos
Endoscopia por Cápsula , Enteropatias , Humanos , Enteropatias/diagnóstico por imagem , Enteropatias/terapia , Intestino Delgado/diagnóstico por imagem , Portugal
2.
Rev Esp Enferm Dig ; 111(1): 71-72, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30238763

RESUMO

In the study of obscure gastrointestinal bleeding, which includes iron-deficiency anemia, the capsule endoscopy is a valuable diagnostic tool. In the different series the presence of tumors reaches 16% as the cause of it. We present the case of a rare tumor with metastatic extension in the small intestine in which the capsule endoscopy was key to the diagnosis and survival of the patient.


Assuntos
Endoscopia por Cápsula , Dermatofibrossarcoma/secundário , Neoplasias Duodenais/secundário , Neoplasias do Jejuno/secundário , Neoplasias Pulmonares/secundário , Neoplasias Cutâneas/patologia , Adulto , Nádegas , Dermatofibrossarcoma/diagnóstico por imagem , Dermatofibrossarcoma/terapia , Neoplasias Duodenais/diagnóstico por imagem , Humanos , Neoplasias do Jejuno/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Masculino , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
3.
Dig Endosc ; 30(4): 461-466, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29253321

RESUMO

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. METHODS: 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. RESULTS: 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. CONCLUSION: Capsule endoscopy may be a moderately helpful and safe diagnostic tool in the suspicion of complicated CD, modifying the clinical course of these patients.


Assuntos
Endoscopia por Cápsula/métodos , Doença Celíaca/diagnóstico , Dieta Livre de Glúten , Mucosa Intestinal/patologia , Adulto , Doença Celíaca/dietoterapia , Estudos de Coortes , Progressão da Doença , Feminino , Seguimentos , Humanos , Intestino Delgado/patologia , Intestino Delgado/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Adulto Jovem
4.
Rev Esp Enferm Dig ; 109(5): 322-327, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28229607

RESUMO

INTRODUCTION: Colon capsule endoscopy (CCE) is an alternative approach for the examination of the colon in patients who refuse colonoscopy or after incomplete colonoscopy (IC). We conducted a study to determine the frequency of complete colonoscopy after IC, the diagnostic yield of CCE, the therapeutic impact of lesions found in CCE, the level of colon cleanliness and the safety of the procedure. METHODS: We performed a prospective, multicenter study involving ten Spanish hospitals. Consecutive outpatients aged ≥ 18 years with previous IC were invited to participate. The latest version of the CCE device, PillCam™ COLON 2 (CCE-2), was administered to all patients according to the protocol. RESULTS: The study population comprised 96 patients. The most frequent cause of IC was the inability to move past a loop using standard maneuvers (75/96 patients, 78%). Complete visualization of the colon was obtained with CCE-2 in 69 patients (71.9%). Of the 27 patients in whom the CCE-2 did not reach the hemorrhoidal plexus, it passed the colonic segment explored with the previous colonoscopy in 20 cases; therefore, it could be inferred that a combined approach (CCE-2 plus colonoscopy) enabled complete visualization of the colonic mucosa in 92.7% of patients. CCE-2 revealed new lesions in 58 patients (60.4%). Polyps were the most frequent finding (41 patients; 42.7% of the total number of patients). In 43 of the 58 patients (44.8% of the total number of patients), the new lesions observed led to modification of therapy, which included a new colonoscopy for polyp resection or surgery in patients with colonic neoplasm. CONCLUSIONS: CCE-2 is a suitable diagnostic procedure that can lead to more frequent diagnosis of significant colonic lesions after IC.


Assuntos
Endoscopia por Cápsula/instrumentação , Colo/diagnóstico por imagem , Neoplasias do Colo/diagnóstico por imagem , Pólipos do Colo/diagnóstico por imagem , Colonoscopia , Diverticulose Cólica/diagnóstico por imagem , Mucosa Intestinal/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Espanha
5.
Rev Esp Enferm Dig ; 109(2): 91-105, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27990836

RESUMO

High resolution esophageal manometry (HRM) is currently under development as can be seen in the various Chicago classifications. In order to standardize criteria in certain practical aspects with limited scientific evidence, the First National Meeting for Consensus in High Resolution Manometry of the Spanish Digestive Motility Group took place, bringing together a wide group of experts. The proposals were based on a prior survey composed of 47 questions, an exhaustive review of the available literature and the experience of the participants. Methodological aspects relating to the poorly defined analysis criteria of certain new high resolution parameters were discussed, as well as other issues previously overlooked such as spontaneous activity or secondary waves. Final conclusions were drawn with practical applications.


Assuntos
Doenças do Esôfago/diagnóstico por imagem , Esôfago/diagnóstico por imagem , Manometria/métodos , Anestesia , Consenso , Motilidade Gastrointestinal , Humanos
6.
Endosc Int Open ; 12(3): E344-E351, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38481597

RESUMO

Background and study aims In 2019, the European Society of Gastrointestinal Endoscopy (ESGE) created a working group to develop technical and quality standards for small-bowel capsule endoscopy (SBCE) to improve the daily practice of endoscopy services. They developed 10 quality parameters, which have yet to be tested in a real-life setting. Our study aimed to evaluate the accomplishment of the quality standards in SBCE established by the ESGE in several Spanish centers. Materials and methods An online survey of 11 multiple-choice questions related to the ESGE performance measures was sent to Spanish centers with experience in SBCE. In order to participate and obtain reliable data, at least 100 questionnaires had to be answered per center because that is the minimum number established by ESGE. Results 20 centers participated in the study, compiling 2049 SBCEs for the analysis. Only one of 10 performance measures (cecal visualization) reached the minimum standard established by the ESGE. In five of 10 performance measures (Indication, lesion detection rate, terminology, and retention rate) the minimum standard was nearly achieved. Conclusions Our study is the first multicenter study regarding SBCE quality performance measures in a real setting. Our results show that the minimum standard is hardly reached in most procedures, which calls into question their clinical applicability in real life. We suggest performing similar studies in other countries to evaluate whether there is a need for quality improvement programs or a need to reevaluate the minimum and target values published so far.

7.
GE Port J Gastroenterol ; 27(5): 324-335, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32999905

RESUMO

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication and on its diagnostic and therapeutic yields. A set of recommendations were issued accordingly.


Estas recomendações baseadas na evidência detalham o uso da enteroscopia assistida por dispositivo no manejo clínico das doenças do intestino delgado. Um conjunto de Gastrenterologistas diferenciados em patologia do intestino delgado foi selecionado pelos grupos de estudos Espanhol e Portugués de intestino delgado para rever a evidência disponível sobre as principais indicações desta técnica, o seu papel nos algoritmos de manejo de cada indicação e sobre o seu rendimento diagnóstico e terapêutico. Foi gerado um conjunto de recomendações pelos autores.

8.
World J Gastroenterol ; 23(4): 703-711, 2017 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-28216978

RESUMO

AIM: To analyze the diagnostic yield (DY), therapeutic impact (TI) and safety of capsule endoscopy (CE). METHODS: This is a multi-centre, observational, analytical, retrospective study. A total of 163 patients with suspicion of celiac disease (CD) (mean age = 46.4 ± 17.3 years, 68.1% women) who underwent CE from 2003 to 2015 were included. Patients were divided into four groups: seronegative CD with atrophy (Group-I, n = 19), seropositive CD without atrophy (Group-II, n = 39), contraindication to gastroscopy (Group-III, n = 6), seronegative CD without atrophy, but with a compatible context (Group-IV, n = 99). DY, TI and the safety of CE were analysed. RESULTS: The overall DY was 54% and the final diagnosis was villous atrophy (n = 65, 39.9%), complicated CD (n = 12, 7.4%) and other enteropathies (n = 11, 6.8%; 8 Crohn's). DY for groups I to IV was 73.7%, 69.2%, 50% and 44.4%, respectively. Atrophy was located in duodenum in 24 cases (36.9%), diffuse in 19 (29.2%), jejunal in 11 (16.9%), and patchy in 10 cases (15.4%). Factors associated with a greater DY were positive serology (68.3% vs 49.2%, P = 0.034) and older age (P = 0.008). On the other hand, neither sex nor clinical presentation, family background, positive histology or HLA status were associated with DY. CE results changed the therapeutic approach in 71.8% of the cases. Atrophy was associated with a greater TI (92.3% vs 45.3%, P < 0.001) and 81.9% of the patients responded to diet. There was one case of capsule retention (0.6%). Agreement between CE findings and subsequent histology was 100% for diagnosing normal/other conditions, 70% for suspected CD and 50% for complicated CD. CONCLUSION: CE has a high DY in cases of suspicion of CD and it leads to changes in the clinical course of the disease. CE is safe procedure with a high degree of concordance with histology and it helps in the differential diagnosis of CD.


Assuntos
Endoscopia por Cápsula , Doença Celíaca/diagnóstico por imagem , Gastroscopia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atrofia , Criança , Dieta Livre de Glúten , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Prevalência , Estudos Retrospectivos , Adulto Jovem
9.
Rev. esp. enferm. dig ; 109(5): 322-327, mayo 2017. tab, ilus, graf
Artigo em Inglês | IBECS (Espanha) | ID: ibc-162693

RESUMO

Introduction: Colon capsule endoscopy (CCE) is an alternative approach for the examination of the colon in patients who refuse colonoscopy or after incomplete colonoscopy (IC). We conducted a study to determine the frequency of complete colonoscopy after IC, the diagnostic yield of CCE, the therapeutic impact of lesions found in CCE, the level of colon cleanliness and the safety of the procedure. Methods: We performed a prospective, multicenter study involving ten Spanish hospitals. Consecutive outpatients aged ≥ 18 years with previous IC were invited to participate. The latest version of the CCE device, PillCam(TM) COLON 2 (CCE-2), was administered to all patients according to the protocol. Results: The study population comprised 96 patients. The most frequent cause of IC was the inability to move past a loop using standard maneuvers (75/96 patients, 78%). Complete visualization of the colon was obtained with CCE-2 in 69 patients (71.9%). Of the 27 patients in whom the CCE-2 did not reach the hemorrhoidal plexus, it passed the colonic segment explored with the previous colonoscopy in 20 cases; therefore, it could be inferred that a combined approach (CCE-2 plus colonoscopy) enabled complete visualization of the colonic mucosa in 92.7% of patients. CCE-2 revealed new lesions in 58 patients (60.4%). Polyps were the most frequent finding (41 patients; 42.7% of the total number of patients). In 43 of the 58 patients (44.8% of the total number of patients), the new lesions observed led to modification of therapy, which included a new colonoscopy for polyp resection or surgery in patients with colonic neoplasm. Conclusions: CCE-2 is a suitable diagnostic procedure that can lead to more frequent diagnosis of significant colonic lesions after IC (AU)


No disponible


Assuntos
Adulto , Pessoa de Meia-Idade , Humanos , Endoscopia por Cápsula/métodos , Endoscopia por Cápsula/tendências , Colonoscopia/métodos , Pólipos do Colo , Neoplasias do Colo , Midazolam/uso terapêutico , Estudos Prospectivos , Divertículo , Propofol/uso terapêutico
10.
Rev. esp. enferm. dig ; 109(2): 91-105, feb. 2017. tab, ilus
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-159852

RESUMO

La manometría esofágica de alta resolución (MAR) está en fase de desarrollo, como se evidencia por las diferentes clasificaciones de Chicago. Con el fin de unificar criterios en algunos aspectos prácticos con limitada evidencia científica se llevó a cabo la Primera Reunión Nacional de Consenso en Manometría de Alta Resolución del Grupo Español de Motilidad Digestiva, en la que participaron un amplio grupo de expertos. Las propuestas se basaron en una encuesta previa con 47 preguntas, la exhaustiva revisión de la bibliografía disponible y la experiencia de los participantes. Se plantearon aspectos metodológicos sobre criterios de análisis poco definidos de algunos nuevos parámetros de alta resolución y otros aspectos no considerados, como la actividad espontánea o las ondas secundarias, elaborándose conclusiones finales con utilidad práctica (AU)


High resolution esophageal manometry (HRM) is currently under development as can be seen in the various Chicago classifications. In order to standardize criteria in certain practical aspects with limited scientific evidence, the First National Meeting for Consensus in High Resolution Manometry of the Spanish Digestive Motility Group took place, bringing together a wide group of experts. The proposals were based on a prior survey composed of 47 questions, an exhaustive review of the available literature and the experience of the participants. Methodological aspects relating to the poorly defined analysis criteria of certain new high resolution parameters were discussed, as well as other issues previously overlooked such as spontaneous activity or secondary waves. Final conclusions were drawn with practical application (AU)


Assuntos
Humanos , Masculino , Feminino , Manometria/instrumentação , Manometria/métodos , Manometria , Conferências de Consenso como Assunto , Sociedades Médicas/organização & administração , Sociedades Médicas/normas , Anestesia/tendências , Anestesia , Administração Tópica , Motilidade Gastrointestinal , Motilidade Gastrointestinal/fisiologia , Transtornos da Motilidade Esofágica/induzido quimicamente , Transtornos da Motilidade Esofágica/complicações , Contração Muscular , Perfusão/métodos
11.
Rev. esp. enferm. dig ; 108(3): 158-162, mar. 2016. ilus
Artigo em Espanhol | IBECS (Espanha) | ID: ibc-148611

RESUMO

La enfermedad de Whipple es una infección sistémica crónica producida por el actinomiceto Tropheryma whipplei. Las pruebas endoscópicas son claves en el diagnóstico ya que permiten la toma de biopsia y su estudio anatomopatológico para el diagnóstico definitivo de esta entidad. Presentamos un caso de enfermedad de Whipple en el que la cápsula endoscópica, poco común para el diagnóstico de esta afección, fue clave para el mismo y su realización antes y después del tratamiento antibiótico permite describir la evolución macroscópica de los hallazgos en intestino delgado. Este caso ilustra la utilidad de la cápsula endoscópica al permitir un estudio completo del intestino delgado en esta enfermedad en la que hasta el 30% de los pacientes puede cursar con gastroscopia normal (AU)


Whipple´s disease is a chronic systemic infection produced by the actinomycete Tropheryma whipplei. Endoscopic tests are key in the diagnosis as they allow biopsy and histopathological examination for definitive diagnosis of this entity. We present a case of Whipple´s disease where capsule endoscopy, uncommon for the diagnosis of this condition, was essential for it and its performance before and after antibiotic treatment allows to describe the macroscopic evolution of the findings in the small bowel. This case illustrates the utility of capsule endoscopy to allow complete examination of the small bowel disease in which up to 30% of patients may present with normal endoscopy (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Doença de Whipple/complicações , Doença de Whipple , Endoscopia por Cápsula/instrumentação , Endoscopia por Cápsula/métodos , Endoscopia por Cápsula/tendências , Cápsulas Endoscópicas/tendências , Cápsulas Endoscópicas , Histiócitos/patologia , Histiócitos , Gastroscopia/instrumentação , Gastroscopia/métodos , Gastroscopia , Xantomatose/complicações , Xantomatose , Colonoscopia/métodos , Colonoscopia/tendências , Colonoscopia
12.
Gastroenterol. hepatol. (Ed. impr.) ; 44(10): 680-686, Dic. 2021. tab, ilus, graf
Artigo em Inglês | IBECS (Espanha) | ID: ibc-222069

RESUMO

Background: Small Bowel Capsule Endoscopy is the first-choice technique for investigating the majority of small bowel diseases. Its most common complications are related to incomplete examinations and capsule retention. There is no consensus on how patients with previous gastrointestinal surgery should receive the capsule. Objective: The primary endpoint was to compare the rate of complete small-bowel examinations (completion rate) between oral ingestion and endoscopic delivery of the capsule. The secondary endpoint was to compare diagnostic yield and adverse events in the two groups. Methods: A retrospective observational study was conducted in nine hospitals in Spain. Demographic data, previous surgery, indication for capsule endoscopy, intestinal transit time, diagnosis, completion rate (percentage of capsules reaching the caecum), diagnostic yield (percentage of results compatible with indication for the exam) and adverse events were collected. Results: From January 2009 to May 2019 fifty-seven patients were included (39 male, mean age 66±15 years). The most common indications for the exam were “overt” (50.9%) and “occult” (35.1%) small bowel bleeding. Previous Billroth II gastrectomy and Roux-en-Y gastric bypass were present in 52.6% and 17.5% of patients respectively. The capsule was swallowed in 34 patients and placed endoscopically in 23 patients. No significant differences were observed between the oral ingestion and endoscopic delivery groups in terms of completion rate (82.4% vs. 78.3%; p=0.742), diagnostic yield (41.2% vs. 52.2%; p=0.432) or small bowel transit time (301 vs. 377min, p=0.118). No capsule retention occurred. Only one severe adverse event (anastomotic perforation) was observed in the endoscopic delivery group. Conclusions: In our case series, there were no significant differences between oral ingestion and endoscopic delivery in terms of completion rate, diagnostic yield or safety.(AU)


Antecedentes: La cápsula endoscópica representa la técnica de primera elección para investigar la mayoría de las enfermedades del intestino delgado. Sus complicaciones más comunes frecuentes son las exploraciones incompletas y la retención a nivel de intestino delgado. Hasta el momento no hay acuerdo sobre cómo administrar la cápsula a los pacientes que han sido sometidos a una cirugía gastrointestinal previa. Objetivo: El objetivo principal fue comparar la tasa de estudios completos entre la ingestión oral y la administración endoscópica de la cápsula. Los objetivos secundarios fueron comparar el rendimiento diagnóstico y los eventos adversos en ambos grupos. Métodos: Se realizó un estudio observacional retrospectivo en 9 hospitales de España. Se recogieron datos demográficos, cirugía previa, indicación de cápsula endoscópica, tiempo de tránsito intestinal, diagnóstico, tasa de estudios completos (porcentaje de cápsulas que llegan al ciego), rendimiento diagnóstico (porcentaje de resultados compatibles con la indicación del examen) y eventos adversos. Resultados: Desde enero de 2009 hasta mayo de 2019 se incluyeron 57 pacientes (39 hombres, edad media 66 ± 15 años). Las indicaciones más frecuentes para el examen fueron hemorragia de intestino delgado «manifiesta» (50,9%) y «oculta» (35,1%). El 52,6% de los pacientes presentaba gastrectomía Billroth II y el 17,5% bypass gástrico en Y de Roux. La cápsula fue ingerida en 34 pacientes y colocada endoscópicamente en 23 pacientes. No se observaron diferencias significativas entre los grupos de ingesta oral y de colocación endoscópica en cuanto a tasa de estudios completos (82,4% vs. 78,3%; p = 0,742), rendimiento diagnóstico (41,2% vs. 52,2%; p = 0,432) y tiempo de tránsito del intestino delgado (301 vs. 377 min, p = 0,118). No hubo casos de cápsulas retenidas. Solo se observó un evento adverso severo (perforación anastomótica) en el grupo de colocación endoscópica...(AU)


Assuntos
Humanos , Gastroscopia , Intestino Delgado , Endoscopia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Derivação Gástrica , Espanha , Gastroenterologia , Gastroenteropatias , Estudos Retrospectivos , Estudos de Coortes
13.
Rev. esp. enferm. dig ; 112(4): 309-318, abr. 2020. tab
Artigo em Inglês | IBECS (Espanha) | ID: ibc-187512

RESUMO

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small-bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication, and its diagnostic and therapeutic yield. A set of recommendations was issued accordingly


No disponible


Assuntos
Humanos , Enteroscopia de Balão/métodos , Intestino Delgado/cirurgia , Hemorragia Gastrointestinal/cirurgia , Endoscopia por Cápsula/métodos , 16595/etiologia , Doença de Crohn/cirurgia , Polipose Intestinal/cirurgia , Doença Celíaca/cirurgia , Guias de Prática Clínica como Assunto , Sangue Oculto , Portugal , Espanha
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