PWE-144 Small Bowel Capsule Endoscopy in Patients with Cirrhosis: the Edinburgh Experience

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Abstract

Introduction

Portal hypertensive enteropathy (PHE) remains difficult to diagnose in patients with cirrhosis and portal hypertension. Limited test choices exist for the inspection of the small bowel in these patients. Small bowel capsule endoscopy (SBCE) would be ideal in this situation but it is rarely performed.1–3

Aim

We aimed to determine the prevalence of PHE using SBCE in a cirrhotic patient population from our centre.

Methods

This was a retrospective study using the SBCE data base of our unit. We searched through 1,477 patients that had SBCE between 2005 and 2013. Patients with cirrhosis who underwent SBCE were identified, data retrieved and abstracted. The Fischer’s exact or the chi-square tests were used to compare between groups. A two-tailed P value of <0.05 was considered statistically significant.

Results

We identified 53 patients with cirrhosis who underwent SCBE. We used PillCam®SB (Given®Imaging Ltd, Israel) system on 36 patients and the MiroCam® capsule (IntroMedic Co, Korea) on 17 patients. Thirty patients were referred for iron deficiency anaemia, 15 for obscure gastrointestinal bleeding, and 4 for other indications.

Results

Four data sets were not available for review at the time of the study, leaving 49 patients to be reviewed. Mean age was 61.19 ± 14.54 years (M/F=27/22). Table 1 shows the aetiologies of liver disease in these patients. Six SBCE examinations were incomplete. Thirty three patients had evidence of portal hypertensive gastropathy (PHG) and 17 patients had evidence of oesophageal varices. In total, 29 patients had SCBE evidence of PHE (67%). 28/29 (96.5%) of patients with PHE had also evidence of PHG. 13/17 (76.4%) patients with oesophageal varices had also evidence of PHE.

Results

Our mean follow up was 58.0 ± 13.7 months. Twenty patients died during the follow up period. There was no correlation between the presence of PHE and aetiology of liver disease (P = 0.4261) or subsequent death (P= 0.2145).

Conclusion

The prevalence of PHE in our study was 67%. SBCE is a useful tool in evaluating PHE in cirrhotic patients irrespective of aetiology.

Disclosure of Interest

None Declared.

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