Document Detail


Head or tail: the orientation of the small bowel capsule endoscope movement in the small bowel.
MedLine Citation:
PMID:  21960284     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: The diagnostic accuracy of capsule endoscopy has been suggested to be influenced by the direction of the passage in the intestine. It is currently unknown if a head-first or a tail-first orientation are equally common during the descent through the small bowel. The aim of the study was to identify the orientation of the capsule along the migration through the small bowel.
METHODS: Thirty capsule endoscopies were reviewed by an experienced observer. The direction of the passage through the pylorus and the ileoceccal valve was recorded for all the examinations. In addition, detailed review of the passage of the capsule in different segments of the small bowel was undertaken for all the capsules.
RESULTS: The capsule was significantly more likely to pass the pylorus head-first compared to tail-first (25 and 5 out of 30, respectively, OR 5, 95% CI 65-94%, P < 0.001). In 28/30 studies, the capsule exited the ileoceccal valve head-first (OR-14, 95% CI 77-99%, P < 0.001). In an immersion experiment, uneven distribution of weight of the capsule body was demonstrated with the head part (camera tip) being lighter than the tail part.
CONCLUSIONS: The capsule endoscope usually passes through the pylorus and subsequent segments of the small bowel head-first. This observation suggests that the intestinal peristaltic physiology drives symmetrical bodies with their light part first. The principle of intestinal orientation by weight distribution may bear implications for capsules' design in the future.
Authors:
Uri Kopylov; Neofytos P Papageorgiou; Moshe Nadler; Rami Eliakim; Shomron Ben-Horin
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Publication Detail:
Type:  Clinical Trial; Journal Article; Validation Studies     Date:  2011-09-29
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  57     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-21     Completed Date:  2012-04-10     Revised Date:  2012-04-24    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  694-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel. ukopylov@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / pathology
Adult
Anemia / pathology
Capsule Endoscopes / standards*
Capsule Endoscopy* / instrumentation,  methods,  standards
Diarrhea / pathology
Equipment Design
Female
Gastrointestinal Diseases / pathology,  physiopathology*
Gastrointestinal Motility / physiology*
Humans
Ileocecal Valve / pathology,  physiology
Intestine, Small / pathology,  physiology*
Male
Middle Aged
Pylorus / pathology,  physiology
Reference Values
Reproducibility of Results
Comments/Corrections
Comment In:
Dig Dis Sci. 2012 Apr;57(4):1102-3; author reply 1103-4   [PMID:  22350784 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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