IRISH SOCIETY OF GASTROENTEROLOGY 2021
Endoscopy Poster Awards 2021 - First Prize
Dr Fintan O’Hara
Tallaght University Hospital Dublin
Retrospective Analysis Of The Utility Of Patency Capsule Prior To Capsule Endoscopy
F. O'Hara, C. Walker, S. O'Donnell, A. O'Connor, N. Breslin, B. Ryan, D. McNamara
Tallaght University Hospital, Dublin
Retention in capsule endoscopy (CE) remains a major complication with rates ranging from 1% to 5%. Investigations to rule out strictures prior to CE in at risk groups are recommended. The Agile Patency Capsule Test (PCT) is designed specifically to out rule relevant strictures. The PPV of PCT is unclear and its expanded use may unnecessarily prevent patients from undergoing CE.
To assess the impact of PC in a capsule endoscopy cohort.
We performed a retrospective review of PCT’s performed in TUH over 1 year from July 2020-2021. Patient demographics, indication for CE, PCT indication and result and CE findings were recorded. Indication for PCT was validated according to ESGE guidelines.
In all 166 (15%) of 1127 CE referrals were deemed to require a PCT. PCT indication was appropriate in 88% (n=145) including known Crohn’s 26%, prior GI surgery 28%, regular NSAID’s 14%, abnormal radiology 10%, obstructive symptoms 6% and other 4%. Of inappropriate PCT’s, 92% (n=19) were referred with suspected Crohn’s disease only. Overall 43% (n=71) failed the PCT, rates were similar for appropriate and inappropriate studies 62/145 (42%) and 10/21 (48%), p<0.3. No patients who passed the PCT had a retention and there were no PCT associated A/E’s during this period.
Our unit has a high compliance with current guidelines for patency assessment. PCT’s are an effective means of reducing retention in at risk groups. The high failure rate (43%) warrants further investigation to avoid the unnecessary exclusion of patients from CE.