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Small bowel patency assessment using the patency device and a novel targeted (limited radiation) computed tomography‐based protocol
Author(s) -
Assadsangabi Arash,
Blakeborough Anthony,
Drew Kaye,
Lobo Alan J,
Sidhu Reena,
McAlindon Mark E
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12891
Subject(s) - medicine , radiology , capsule endoscopy , abdominal computed tomography , tomography , abdomen , nuclear medicine
Background and Aim Excretion of the patency capsule ( PC ) within a certain time frame may be used to demonstrate luminal patency prior to capsule endoscopy ( CE ). We aimed to determine how often further radiological imaging is needed to confirm luminal patency after PC , assess radiologists' ability to locate the PC on plain abdominal films, and evaluate the outcomes of a novel computed tomography ( CT ) protocol for PC localization. Methods A study of the ability of radiologists to localize PC using plain abdominal films was performed. A novel protocol targeting a limited CT at the level of the PC identified on the “scout” film if retained 30 h post‐ingestion was prospectively evaluated in 400 consecutive patients undergoing PC . Results In a study of the confidence with which radiologists could localize the PC on plain films, radiologists preferred abdominal CT to localize PCs identified on plain films in 74% of cases. In a protocol based on the use of a PC and targeted, limited CT scan to confirm small bowel patency in those failing to excrete the PC 30 h post‐ingestion, the sensitivity, specificity, positive, and negative predictive value were 99.4%, 90.0%, 99.7%, and 81.0%, respectively. C rohn's disease was the only statistically significant predictor associated with higher risk of luminal stricture ( P = 0.001) in post‐hoc analysis. Conclusions Excretion of the PC 30 h post‐ingestion reliably predicts safe CE passage. Plain abdominal radiology is unreliable and a scout film targeted, limited CT scan offers an accurate minimal radiation method of determining small bowel patency.