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Gastrointest Endosc. 2015 Jan;81(1):186-93. doi: 10.1016/j.gie.2014.04.062. Epub 2014 Jul 8.

Small-bowel capsule endoscopy in patients with unexplained chronic abdominal pain: a systematic review.

Author information

1
Department of Gastroenterology, Sir Runrun Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Institute of Gastroenterology, Zhejiang University, Hangzhou, China.
2
Department of Ultrasound, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
3
Institute of Gastroenterology, Zhejiang University, Hangzhou, China; Department of Gastroenterology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Abstract

BACKGROUND:

Patients frequently consult primary care physicians and gastroenterologists when experiencing chronic abdominal pain. Although its diagnostic efficacy in these settings is uncertain, small-bowel capsule endoscopy (SBCE) has been used to evaluate the unexplained reasons for abdominal pain.

OBJECTIVE:

To evaluate the diagnostic yield of SBCE in patients with unexplained chronic abdominal pain.

DESIGN:

We performed a retrospective review of publications reporting the diagnostic yield of SBCE in patients with unexplained chronic abdominal pain and calculated the overall diagnostic yield.

SETTING:

Two investigators independently searched studies from databases and analyzed the results.

PATIENTS:

A total of 1520 patients from 21 studies were included.

INTERVENTIONS:

Small-bowel capsule endoscopy.

MAIN OUTCOME MEASUREMENTS:

Per-patient diagnostic yield, with 95% confidence intervals (CI), was evaluated by a random-effect model. Clear categorical analysis also was performed.

RESULTS:

The pooled diagnostic yield of SBCE in patients with unexplained chronic abdominal pain was 20.9% (95% CI, 15.9%-25.9%), with high heterogeneity (I(2) = 80.0%; P < .001). Inflammatory lesions were the most common (78.3%) positive findings, followed by tumors (9.0%).

LIMITATIONS:

Heterogeneity among studies, retrospective design, variable chronicity of abdominal pain, and different previous examinations before SBCE.

CONCLUSION:

SBCE provides a noninvasive diagnostic tool for patients with unexplained chronic abdominal pain, but the diagnostic yield is limited (20.9%). Among patients with positive findings, inflammatory lesions are the most common.

PMID:
25012561
DOI:
10.1016/j.gie.2014.04.062
[Indexed for MEDLINE]

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