Clin Endosc.  2018 Nov;51(6):563-569. 10.5946/ce.2018.041.

Mucosal Changes in the Small Intestines in Portal Hypertension: First Study Using the Pillcam SB3 Capsule Endoscopy System

Affiliations
  • 1Institute of Gastro-Sciences, Apollo Gleneagles Hospitals, Kolkata, India. mkgkolkata@gmail.com
  • 2Department of Clinical Imaging and Interventional Radiology, Apollo Gleneagles Hospitals, Kolkata, India.

Abstract

BACKGROUND/AIMS
To evaluate patients with portal hypertension (PH) of varied etiologies for portal hypertensive enteropathy (PHE) using the PillCam SB3 capsule endoscopy (CE) system.
METHODS
Consecutive patients with PH presenting with unexplained anemia and/or occult gastrointestinal bleeding were evaluated using the PillCam SB3 CE system. Abnormal findings were categorized as vascular or non-vascular. The patients with ongoing bleeding caused by PHE were treated. The correlation of the CE scores of PHE with the clinical, laboratory, and endoscopic features was determined.
RESULTS
Of the 43 patients included in the study, 41 (95.3%) showed PHE findings. These included varices (67.4%), red spots (60.5%), erythema (44.2%), villous edema (46.5%), telangiectasia (16.3%), and polyps (16.3%). The CE scores varied from 0 to 8 (mean±standard deviation, 4.09±1.8). Five patients (11.6%) showed evidence of ongoing or recent bleeding due to PHE. Three of these five patients underwent endotherapy, and one patient underwent radiological coil placement.
CONCLUSIONS
The PillCam SB3 CE system revealed a high prevalence of PHE in the patients with PH. Using this system, evidence of bleeding due to PHE was found in a small but definite proportion of the patients.

Keyword

Capsule endoscopy; Intestine, small; Hypertension, portal; Cirrhosis; PillCam SB3
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