Published in:
01-10-2011 | Case Report
Incomplete capsule endoscopy examinations after Roux-en-Y gastric bypass
Published in: Clinical Journal of Gastroenterology | Issue 5/2011
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Background
Video capsule endoscopy is an important tool for minimally invasive evaluation of the small bowel. Optimization of this imaging modality has focused on minimizing the rate of incomplete studies through appropriate patient selection. Recent data have shown an increased incidence of incomplete examinations in those with surgically altered gastrointestinal anatomy.
Methods
We present 4 consecutive cases of post Roux-en-Y gastric bypass patients undergoing video capsule endoscopy.
Results
Three patients were referred for obscure gastrointestinal bleeding and one for diagnosis of Crohn’s disease; all 4 patients had incomplete studies. One patient experienced capsule retention in the gastric pouch. Two patients had repeated poor small bowel preparation despite compliance with preparatory methods. The fourth patient experienced delayed gastrointestinal transit despite satisfactory small bowel preparation.
Conclusion
Patients with a history of Roux-en-Y surgery appear to be at increased risk for incomplete examination due to capsule retention and delayed gastric transit. Endoscopists may consider additional precursory testing or the use of alternative imaging methods in this population.