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Name of journal: World Journal of GastroenterologyESPS Manuscript NO: 29771Manuscript type: ReviewContraindications for video capsule endoscopy Bandorski D et al. Contraindications for capsule endoscopy Dirk Bandorski, Niehls Kurniawan, Peter Baltes, Reinhard Hoeltgen, Matthias Hecker, Dominic Stunder, Martin KeuchelDirk Bandorski, Matthias Hecker, University of Giessen and Marburg Lung Center (UGMLC) Giessen, Klinikstrasse, 35392 Giessen, GermanyNiehls Kurniawan, Peter Baltes, Martin Keuchel, Clinic for Internal Medicine, Bethesda Krankenhaus Bergedorf, Glindersweg, 21029 Hamburg, GermanyReinhard Hoeltgen, Klinikum Westmünsterland, St. Agnes-Hospital Bocholt Rhede, Medical Clinic 1 Cardiology/Electrophysiology, Barloer Weg, 46397 Bocholt GermanyDominic Stunder, Research Center for Bioelectromagnetic Interaction (femu), Institute of Occupational and Social Medicine, RWTH Aachen University Hospital, Pauwelsstrasse, 52074 Aachen, GermanyAuthor contributions: Each author wrote a part of the paper; Bandorski D and Stunder D analyzed technical data of capsule endoscopy and implantable cardiac devices. Conflict-of-interest statement: Baltes P and Keuchel M have received lecture fees from Covidien, Medtronic, Olympus; the other authors have nothing to declare.Open-Access: This article is an open-access?article?which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance?with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: : Invited?manuscriptCorrespondence to: Dirk Bandorski, MD, FESC, FACC, University of Giessen and Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL), Klinikstrasse 33, 35392 Giessen, Germany. dirk.bandorski@khw.med.uni-giessen.deTelephone: +49-641-98542351Fax: +49-641-98542359Received: August 27, 2016Peer-review started: August 31, 2016First decision: September 12, 2016Revised: October 9, 2016Accepted: November 14, 2016Article in press:Published online:AbstractVideo capsule endoscopy (VCE) has been applied in the last 15 years in an increasing field of applications. Although many contraindications have been put into perspective, some precautions still have to be considered. Known stenosis of the gastrointestinal tract is a clear contraindication for VCE unless surgery is already scheduled or at least has been considered as an optional treatment modality. In patients with a higher incidence of stenosis, as in an established diagnosis of Crohn’s disease, clinical signs of obstruction, prior radiation or surgical small bowel resection, a preceding test with the self-dissolving patency capsule can override this contraindication. Endoscopic placement of the capsule should be considered in patients with swallowing disorders to avoid aspiration. Esophageal or gastric motility disorders may require endoscopic capsule transport or application of prokinetics if the real-time viewer proofs delayed transit. In pregnant women, VCE should be restricted to urgent cases where diagnosis cannot be postponed after delivery, as data on safety are missing. There is theoretical and clinical evidence that patients with implanted cardiac devices such as a pacemaker, cardioverters or left heart assist devices, can safely undergo VCE in spite of still existing contraindication by manufacturers. Children from the age of 2 years have safely undergone VCE. Although video capsules are not proven safe with magnetic resonance imaging (MRI), first single cases of patients incidentally undergoing MRI with an incorporated capsule have been reported, showing susceptibility artifacts but no signs of clinical harm.Key words: Video capsule endoscopy; contraindications; stenosis; pacemaker; aspiration; pregnancy; Magnetic resonance imaging? The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.core tip: Video capsule endoscopy has emerged as a first line diagnostic tool for small bowel visualization. The few existing contraindications are discussed in this review and put into perspective. Special situations are to be considered for patients with gastrointestinal stenosis, swallowing and motility disorders, or implanted electromagnetic cardiac devices, pregnant women, young children, and magnetic resonance imaging for patients with a retained capsule. Appropriate precautions are discussed in this paper.Bandorski D, Kurniawan N, Baltes P, Hoeltgen R, Hecker M, Stunder D, Keuchel M. Contraindications for video capsule endoscopy. World J Gastroenterol 2016; In pressIntroductionVideo capsule endoscopy (VCE) was introduced in 2001 as a well-tolerated, non-invasive, radiation free, disruptive method to visualize the gastrointestinal (GI) tract, in particular the small bowel. The wireless video capsule consists of one or more cameras with a corresponding lens and light source, batteries, a video chip, and an electronic circuit to either store or transmit the captured images. Depending on the manufacturer, the capsule measures 24-32 mm in length and 11-13 mm in diameter. The capsule is swallowed by the patient and then progresses through the gastrointestinal tract by peristalsis until it is excreted naturally. Only the colon capsule endoscopy needs an additional booster-solution during the procedure. The most commonly used VCE systems transmit the captured images in real-time to an external sensor array and recorder. The transmission technique is based on radiofrequency (Pillcam, Medtronic plc, Dublin, Ireland; EndoCapsule, Olympus Medical Systems Corp., Tokyo, Japan; OMOM capsule, Jinshan Science and Technology Co. Ltd., Chongqing, China) or electrical current via Human Body Communication (MiRoCam, IntroMedic Co. Ltd., Seoul, South Korea). Images captured by the CapsoCam capsule (CapsoVision Inc., Saratoga, CA, United States) are stored on-board in an integrated flash-drive, thus obviating the need for an external recorder, but requiring retrieval of the capsule to download the data ADDIN EN.CITE <EndNote><Cite><Author>Kurniawan</Author><Year>2014</Year><RecNum>3090</RecNum><DisplayText><style face="superscript">[1]</style></DisplayText><record><rec-number>3090</rec-number><foreign-keys><key app="EN" db-id="90s2awa0haz2tmef0pavsawbr2pwv2wrrxfe" timestamp="1471721343">3090</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Kurniawan, Niehls</author><author>Keuchel, Martin</author></authors><secondary-authors><author>Keuchel, Martin</author><author>Hagenmüller, Friedrich</author><author>Tajiri, Hisao</author></secondary-authors></contributors><titles><title>Technology</title><secondary-title>Video Capsule Endoscopy: A Reference Guide and Atlas</secondary-title></titles><pages>15-20</pages><dates><year>2014</year></dates><pub-location>Berlin, Heidelberg</pub-location><publisher>Springer Berlin Heidelberg</publisher><isbn>978-3-662-44062-9</isbn><label>Kurniawan2014</label><urls><related-urls><url>;[1].Based on these properties of VCE systems and the modality of the procedure, contraindications were established by the manufacturers. Up to today, millions of VCE studies have been performed worldwide. For example, Covidien/Medtronic announced that more than 1.5 million PillCam capsules were used by the end of 2014. With this vast clinical experience, many of the initially pronounced contraindications can now be put into perspective.This review summarizes the contraindications to VCE provided by the manufacturers and critically analyzes the theoretical reasons, the existing clinical evidence in the literature and technical data, as well as statements and guidelines of national or international societies. Contraindications for VCE based on manufacturers’ recommendationsListed below (Table 1) are the contraindications and relative contraindications for VCE as stated by the manufacturers. Detailed contraindications are summarized based on the underlying pathophysiology (i.e., radiation enteritis, large small bowel tumor, extensive abdominal surgery, extensive small bowel or colon diverticulosis, GI perforation and fistulas are summarized under GI obstruction/obstacles).VCE in patients at risk for gastrointestinal stenosis Known or suspected obstruction of the gastrointestinal tract bears the risk of capsule retention and consecutive complications. Intestinal obstacles like extensive diverticulosis or fistulas can have a similar effect. Capsule retention is defined by consensus as having a capsule endoscope remaining in the GI tract for a minimum of 14 days or if a directed medical, endoscopic or surgical intervention has to be implemented to retrieve the capsule ADDIN EN.CITE <EndNote><Cite><Author>Cave</Author><Year>2005</Year><RecNum>356</RecNum><DisplayText><style face="superscript">[2]</style></DisplayText><record><rec-number>356</rec-number><foreign-keys><key app="EN" db-id="90s2awa0haz2tmef0pavsawbr2pwv2wrrxfe" timestamp="1447018811">356</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Cave, D.</author><author>Legnani, P.</author><author>de Franchis, R.</author><author>Lewis, B. S.</author></authors></contributors><auth-address>Dept. of Gastroenterology, St. Elizabeth's Medical Center, Brighton, Massachusetts 01655, USA</auth-address><titles><title>ICCE consensus for capsule retention</title><secondary-title>Endoscopy</secondary-title></titles><periodical><full-title>Endoscopy</full-title></periodical><pages>1065-1067</pages><volume>37</volume><number>10</number><reprint-edition>NOT IN FILE</reprint-edition><keywords><keyword>adverse effects</keyword><keyword>Device Removal</keyword><keyword>diagnosis</keyword><keyword>Endoscopy,Gastrointestinal</keyword><keyword>Humans</keyword><keyword>instrumentation</keyword><keyword>Intestinal Diseases</keyword><keyword>methods</keyword><keyword>Miniaturization</keyword><keyword>Practice Guidelines</keyword><keyword>Research Support,Non-U.'t</keyword><keyword>Risk Factors</keyword><keyword>Telemetry</keyword></keywords><dates><year>2005</year></dates><urls><related-urls><url>PM:16189792</url></related-urls></urls></record></Cite></EndNote>[2]. The consequences of capsule retention can be a total or subtotal obstruction ADDIN EN.CITE <EndNote><Cite><Author>Lin</Author><Year>2007</Year><RecNum>1533</RecNum><DisplayText><style face="superscript">[3]</style></DisplayText><record><rec-number>1533</rec-number><foreign-keys><key app="EN" db-id="90s2awa0haz2tmef0pavsawbr2pwv2wrrxfe" timestamp="1447018812">1533</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lin, O. S.</author><author>Brandabur, J. J.</author><author>Schembre, D. B.</author><author>Soon, M. S.</author><author>Kozarek, R. A.</author></authors></contributors><auth-address>Gastroenterology Section, Virginia Mason Medical Center, Seattle, WA 98101, USA</auth-address><titles><title>Acute symptomatic small bowel obstruction due to capsule impaction</title><secondary-title>Gastrointest Endosc</secondary-title></titles><periodical><full-title>Gastrointest Endosc</full-title></periodical><pages>725-728</pages><volume>65</volume><number>4</number><reprint-edition>NOT IN FILE</reprint-edition><keywords><keyword>adverse effects</keyword><keyword>Aged</keyword><keyword>Aged,80 and over</keyword><keyword>Capsule Endoscopy</keyword><keyword>etiology</keyword><keyword>Female</keyword><keyword>Gastroenterology</keyword><keyword>Humans</keyword><keyword>Intestinal Obstruction</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>surgery</keyword></keywords><dates><year>2007</year></dates><work-type>S0016-5107(06)03251-2 pii ;10.1016/j.gie.2006.11.033 doi</work-type><urls><related-urls><url>PM:17383473</url></related-urls></urls></record></Cite></EndNote>[3], gastrointestinal perforationPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5SZXBpY2k8L0F1dGhvcj48WWVhcj4yMDA4PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA [4,5], or capsule disintegration ADDIN EN.CITE <EndNote><Cite><Author>Tacheci</Author><Year>2008</Year><RecNum>236</RecNum><DisplayText><style face="superscript">[6]</style></DisplayText><record><rec-number>236</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Tacheci, I.</author><author>Ryska, A.</author><author>Rejchrt, S.</author><author>Kopacova, M.</author><author>Horava, V.</author><author>Bures, J.</author></authors></contributors><auth-address>Second Department of Internal Medicine, Charles University Faculty of Medicine and Teaching Hospital, Hradec Kralove, Czech Republic. tacheci@</auth-address><titles><title>Spontaneous disintegration of a retained video capsule in a patient with cryptogenic multifocal ulcerous stenosing enteritis: a rare complication</title><secondary-title>Endoscopy</secondary-title></titles><periodical><full-title>Endoscopy</full-title></periodical><pages>E104-5</pages><volume>40 Suppl 2</volume><keywords><keyword>Adult</keyword><keyword>Capsule Endoscopy/ adverse effects</keyword><keyword>Constriction, Pathologic</keyword><keyword>Enteritis/ diagnosis</keyword><keyword>Equipment Failure</keyword><keyword>Fatal Outcome</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Intestine, Small</keyword><keyword>Ulcer/ diagnosis</keyword></keywords><dates><year>2008</year><pub-dates><date>Sep</date></pub-dates></dates><isbn>1438-8812 (Electronic)
0013-726X (Linking)</isbn><accession-num>19085708</accession-num><urls></urls></record></Cite></EndNote>[6]. As these rare complications may occur late in previously asymptomatic patients, retrieval of a retained capsule should be considered. A case report has documented asymptomatic retention for up to 12 years. This 43-year-old patient underwent procto-colectomy for familial adenomatous polyposis (FAP) in 2000 and capsule endoscopy in a pilot study in 2004. The patient was lost at follow-up. In 2016 an abdominal computed tomography (CT) detected the capsule proximal of an anastomotic stricture. After failed endoscopic retrieval, the capsule was recovered surgically ADDIN EN.CITE <EndNote><Cite><Author>Araujo</Author><Year>2016</Year><RecNum>258</RecNum><DisplayText><style face="superscript">[7]</style></DisplayText><record><rec-number>258</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Araujo, A. Ik</author><author>Romero, C.</author><author>Llach, J.</author><author>Castells, A.</author><author>Gonzalez-Suarez, B.</author></authors></contributors><auth-address>Endoscopy Unit. Gastroenterology Department. Hospital Clinic. Barcelona. Spain.
Endoscopy Unit. Gastroenterology Department. Hospital Clinic. Barcelona. Spain.
Endoscopy Unit. Gastroenterology Department. Hospital Clinic. Barcelona. Spain.
Endoscopy Unit. Gastroenterology Department. Hospital Clinic. Barcelona. Spain.
Endoscopy Unit. Gastroenterology Department. Hospital Clinic. Barcelona. Spain. Electronic address: bgonzals@clinic.ub.es.</auth-address><titles><title>Twelve-year asymptomatic retention of a colon capsule endoscopy</title><secondary-title>Gastrointest Endosc</secondary-title></titles><periodical><full-title>Gastrointest Endosc</full-title></periodical><dates><year>2016</year><pub-dates><date>May 5</date></pub-dates></dates><isbn>1097-6779 (Electronic)
0016-5107 (Linking)</isbn><accession-num>27156654</accession-num><urls></urls></record></Cite></EndNote>[7]. This very rare necessity of surgery for retrieval is the reason that some manufacturers include the inability to undergo surgery as a contraindication for VCE.In a systematic review of 22840 VCE procedures, the overall retention rate was as low as 1.4% (CI: 1.2-1.6). Categorized by indication, retention rates in obscure gastro-intestinal bleeding (OGIB) were 1.2% (CI: 0.9-1.6), in Crohn’s disease (definite or suspected) 2.6% (CI 1.6–3.9) and in the neoplastic lesions subgroup 2.1% (CI: 0.7-4.3). Out of 104 reported capsule retentions, 88 were asymptomatic (85%) and 16 had signs of partial or total intestinal obstruction. Of the retained capsules 58.7% were removed surgically, 12.5% endoscopically, or passed either spontaneously or after medical treatment in 15.8%, others were not reported in detail. In 136 cases a cause for retention was reported: Crohn’s disease 35.3%, neoplastic lesions 22.1%, NSAID-induced enteropathy 18.4%, postsurgical stenosis 7.4%, ulceration 3.7%, intestinal adhesion 2.9%, tuberculosis or radiation enteritis each 2.2%, ischemia-induced stenosis, Meckel’s diverticulum or pouch each 1.5%, peptic ulcer scar with stricture or cryptogenic multifocal ulcerous stenosing enteritis each 0.7% ADDIN EN.CITE <EndNote><Cite><Author>Liao</Author><Year>2010</Year><RecNum>276</RecNum><DisplayText><style face="superscript">[8]</style></DisplayText><record><rec-number>276</rec-number><foreign-keys><key app="EN" db-id="t2svzt0tgzw0v3esf5vp9p0zaad5rwv9tdpx" timestamp="1466261268">276</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Liao, Z.</author><author>Gao, R.</author><author>Xu, C.</author><author>Li, Z. S.</author></authors></contributors><auth-address>Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.</auth-address><titles><title>Indications and detection, completion, and retention rates of small-bowel capsule endoscopy: a systematic review</title><secondary-title>Gastrointest Endosc</secondary-title></titles><periodical><full-title>Gastrointest Endosc</full-title></periodical><pages>280-6</pages><volume>71</volume><number>2</number><keywords><keyword>*Capsule Endoscopes</keyword><keyword>Capsule Endoscopy/*adverse effects/*methods</keyword><keyword>Crohn Disease/diagnosis/surgery</keyword><keyword>Equipment Failure</keyword><keyword>Equipment Safety</keyword><keyword>Female</keyword><keyword>Forecasting</keyword><keyword>Gastrointestinal Hemorrhage/diagnosis/surgery</keyword><keyword>Humans</keyword><keyword>Intestinal Diseases/*diagnosis/surgery</keyword><keyword>Intestine, Small/*pathology/surgery</keyword><keyword>Male</keyword><keyword>Prospective Studies</keyword><keyword>Retrospective Studies</keyword><keyword>Risk Assessment</keyword></keywords><dates><year>2010</year><pub-dates><date>Feb</date></pub-dates></dates><isbn>1097-6779 (Electronic)
0016-5107 (Linking)</isbn><accession-num>20152309</accession-num><urls><related-urls><url>;[8]. In addition, case reports documented capsule retention in a Zenker’s diverticulum ADDIN EN.CITE <EndNote><Cite><Author>Ziachehabi</Author><Year>2011</Year><RecNum>118</RecNum><DisplayText><style face="superscript">[9]</style></DisplayText><record><rec-number>118</rec-number><foreign-keys><key app="EN" db-id="sfzwpaxfafe5tqe2wpepxsr9xzp2ta9wzt9z" timestamp="1472020553">118</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ziachehabi, A.</author><author>Maieron, A.</author><author>Hoheisel, U.</author><author>Bachl, A.</author><author>Hagenauer, R.</author><author>Schofl, R.</author></authors></contributors><auth-address>4th Department of Internal Medicine, Elisabethinen Hospital, Linz, Austria. alexander.ziachehabi@elisabethinen.or.at</auth-address><titles><title>Capsule retention in a Zenker's diverticulum</title><secondary-title>Endoscopy</secondary-title></titles><periodical><full-title>Endoscopy</full-title></periodical><pages>E387</pages><volume>43 Suppl 2 UCTN</volume><keywords><keyword>Aged</keyword><keyword>Capsule Endoscopy/*adverse effects</keyword><keyword>Esophagus/*radiography</keyword><keyword>Foreign Bodies/*radiography</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Zenker Diverticulum/*radiography</keyword></keywords><dates><year>2011</year></dates><isbn>1438-8812 (Electronic)
0013-726X (Linking)</isbn><accession-num>22275012</accession-num><urls><related-urls><url>;[9], a duodenal diverticulum ADDIN EN.CITE <EndNote><Cite><Author>Kim</Author><Year>2016</Year><RecNum>83</RecNum><DisplayText><style face="superscript">[10]</style></DisplayText><record><rec-number>83</rec-number><foreign-keys><key app="EN" db-id="sfzwpaxfafe5tqe2wpepxsr9xzp2ta9wzt9z" timestamp="1472020552">83</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Kim, S.</author><author>Bae, S. S.</author><author>Chu, H. J.</author><author>Park, J. H.</author><author>Kyung, G. C.</author><author>An, H. D.</author><author>Kim, K.</author><author>Gang, E. G.</author></authors></contributors><auth-address>Department of Gastroenterology, Hongik Hospital, Seoul, Korea.</auth-address><titles><title>Capsule Endoscopy with Retention of the Capsule in a Duodenal Diverticulum: A Case Report</title><secondary-title>Korean J Gastroenterol</secondary-title></titles><periodical><full-title>Korean J Gastroenterol</full-title></periodical><pages>207-211</pages><volume>67</volume><number>4</number><keywords><keyword>Capsule endoscopy</keyword><keyword>Diverticulum</keyword><keyword>Duodenum</keyword><keyword>Retention</keyword></keywords><dates><year>2016</year><pub-dates><date>Apr 25</date></pub-dates></dates><isbn>1598-9992 (Electronic)
1598-9992 (Linking)</isbn><accession-num>27112247</accession-num><urls><related-urls><url>;[10], in an ileo-rectal fistula ADDIN EN.CITE <EndNote><Cite><Author>Sulz</Author><Year>2008</Year><RecNum>235</RecNum><DisplayText><style face="superscript">[11]</style></DisplayText><record><rec-number>235</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Sulz, M. C.</author><author>Anderson, S. H.</author></authors></contributors><auth-address>Department of Gastroenterology and Hepatology, St. Thomas' Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.</auth-address><titles><title>Wireless capsule retained in an ileorectal fistula in a patient with undiagnosed Crohn's disease</title><secondary-title>Endoscopy</secondary-title></titles><periodical><full-title>Endoscopy</full-title></periodical><pages>E5</pages><volume>40 Suppl 2</volume><keywords><keyword>Capsule Endoscopes/ adverse effects</keyword><keyword>Capsule Endoscopy/ adverse effects/methods</keyword><keyword>Crohn Disease/ complications/diagnosis</keyword><keyword>Diagnosis, Differential</keyword><keyword>Equipment Failure</keyword><keyword>Female</keyword><keyword>Follow-Up Studies</keyword><keyword>Humans</keyword><keyword>Ileal Diseases/ complications/diagnosis/surgery</keyword><keyword>Irritable Bowel Syndrome/diagnosis</keyword><keyword>Laparotomy/methods</keyword><keyword>Rectal Fistula/ complications/diagnosis/surgery</keyword><keyword>Risk Assessment</keyword><keyword>Tomography, X-Ray Computed</keyword><keyword>Young Adult</keyword></keywords><dates><year>2008</year><pub-dates><date>Sep</date></pub-dates></dates><isbn>1438-8812 (Electronic)
0013-726X (Linking)</isbn><accession-num>18283619</accession-num><urls></urls></record></Cite></EndNote>[11], in a epiphrenic diverticulum ADDIN EN.CITE <EndNote><Cite><Author>Rondonotti</Author><Year>2014</Year><RecNum>2950</RecNum><DisplayText><style face="superscript">[12]</style></DisplayText><record><rec-number>2950</rec-number><foreign-keys><key app="EN" db-id="90s2awa0haz2tmef0pavsawbr2pwv2wrrxfe" timestamp="1471802897">2950</key></foreign-keys><ref-type name="Book Section">5</ref-type><contributors><authors><author>Rondonotti, Emanuele</author><author>Martinez, Fernando J.</author><author>Barkin, Jamie</author><author>Gay, Gérard</author><author>Cheng, Michael W.</author></authors><secondary-authors><author>Keuchel, Martin</author><author>Hagenmüller, Friedrich</author><author>Tajiri, Hisao</author></secondary-authors></contributors><titles><title>Complications: Prevention and Management</title><secondary-title>Video Capsule Endoscopy: A Reference Guide and Atlas</secondary-title></titles><pages>413-422</pages><dates><year>2014</year></dates><pub-location>Berlin, Heidelberg</pub-location><publisher>Springer Berlin Heidelberg</publisher><isbn>978-3-662-44062-9</isbn><label>Rondonotti2014</label><urls><related-urls><url>;[12], and the appendix orifice ADDIN EN.CITE <EndNote><Cite><Author>Van Gossum</Author><Year>2003</Year><RecNum>2691</RecNum><DisplayText><style face="superscript">[13]</style></DisplayText><record><rec-number>2691</rec-number><foreign-keys><key app="EN" db-id="90s2awa0haz2tmef0pavsawbr2pwv2wrrxfe" timestamp="1447018812">2691</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Van Gossum, A.</author><author>Francois, E.</author><author>Hittelet, A.</author><author>Schmit, A.</author><author>Deviere, J.</author></authors></contributors><titles><title>A prospective, comparative study between push enteroscopy and wireless video capsule in patients with obscure digestive bleeding 15</title><secondary-title>Gastroenterology</secondary-title></titles><periodical><full-title>Gastroenterology</full-title></periodical><pages>276</pages><volume>125</volume><number>1</number><reprint-edition>NOT IN FILE</reprint-edition><keywords><keyword>Comparative Study</keyword><keyword>diagnosis</keyword><keyword>Endoscopes,Gastrointestinal</keyword><keyword>Endoscopy,Gastrointestinal</keyword><keyword>Gastrointestinal Hemorrhage</keyword><keyword>Human</keyword><keyword>methods</keyword><keyword>Prospective Studies</keyword><keyword>Telemetry</keyword></keywords><dates><year>2003</year></dates><urls><related-urls><url>PM:12870498</url></related-urls></urls></record></Cite></EndNote>[13].An analysis of 5428 VCE procedures in Spain came to a similar conclusion. The overall retention rate was 1.9%, and 1.5% in the OGIB subgroup and 3.3% in the inflammatory bowel disease subgroup. Retention rate raised to 5.7%-30% if at least two of these clinical symptoms were present prior to the VCE study: abdominal pain, distension and nausea/vomiting ADDIN EN.CITE <EndNote><Cite><Author>Fernandez-Urien</Author><Year>2015</Year><RecNum>234</RecNum><DisplayText><style face="superscript">[14]</style></DisplayText><record><rec-number>234</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Fernandez-Urien, I.</author><author>Carretero, C.</author><author>Gonzalez, B.</author><author>Pons, V.</author><author>Caunedo, A.</author><author>Valle, J.</author><author>Redondo-Cerezo, E.</author><author>Lopez-Higueras, A.</author><author>Valdes, M.</author><author>Menchen, P.</author><author>Fernandez, P.</author><author>Munoz-Navas, M.</author><author>Jimenez, J.</author><author>Herrerias, J. M.</author></authors></contributors><auth-address>Digestivo, Complejo Hospitalario de Navarra, Espana.
Universidad de Navarra.
Hospital Clinic. Barcelona.
Hospital Universitario y Politecnico La Fe. Valencia.
Hospital Universitario Virgen Macarena. Sevilla.
Complejo Hospitalario de Toledo. Toledo.
Hospital Virgen de las Nieves. Granada.
Hospital General Universitario Morales Meseguer. Murcia.
Hospital Universitario Virgen de la Arrixaca. Murcia.
Hospital General Universitario Gregorio Maranon Hospital. Madrid.
. Hospital Universitario Marques de Valdecilla. Santander.
Universidad de Navarra.
Complejo Hospital de Pamplona. Navarra.
Hospital Universitario Virgen Macarena. Sevilla.</auth-address><titles><title>Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population</title><secondary-title>Rev Esp Enferm Dig</secondary-title></titles><periodical><full-title>Rev Esp Enferm Dig</full-title></periodical><pages>745-52</pages><volume>107</volume><number>12</number><dates><year>2015</year><pub-dates><date>Dec</date></pub-dates></dates><isbn>1130-0108 (Print)
1130-0108 (Linking)</isbn><accession-num>26671587</accession-num><urls></urls></record></Cite></EndNote>[14]. In patients with suspected GI obstruction a patency test capsule can be administered prior to the actual VCE study. If the capsule is excreted intact within 30 h, GI patency is presumed. After 30 h the lactose body of the patency capsule dissolves, leaving only a slim cellophane coating and a small tagPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TcGFkYTwvQXV0aG9yPjxZZWFyPjIwMDU8L1llYXI+PFJl
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ADDIN EN.CITE.DATA [15]. Passage of an intact patency capsule predicts uneventful VCE ADDIN EN.CITE <EndNote><Cite><Author>Herrerias</Author><Year>2008</Year><RecNum>1049</RecNum><DisplayText><style face="superscript">[16]</style></DisplayText><record><rec-number>1049</rec-number><foreign-keys><key app="EN" db-id="90s2awa0haz2tmef0pavsawbr2pwv2wrrxfe" timestamp="1447018811">1049</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Herrerias, J. M.</author><author>Leighton, J. A.</author><author>Costamagna, G.</author><author>Infantolino, A.</author><author>Eliakim, R.</author><author>Fischer, D.</author><author>Rubin, D. T.</author><author>Manten, H. D.</author><author>Scapa, E.</author><author>Morgan, D. R.</author><author>Bergwerk, A. J.</author><author>Koslowsky, B.</author><author>Adler, S. N.</author></authors></contributors><auth-address>Hospital Virgen de la Macarena, Seville, Spain</auth-address><titles><title>Agile patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy</title><secondary-title>Gastrointest.Endosc.</secondary-title></titles><periodical><full-title>Gastrointest.Endosc.</full-title></periodical><pages>902-909</pages><volume>67</volume><number>6</number><reprint-edition>NOT IN FILE</reprint-edition><keywords><keyword>Capsule Endoscopy</keyword><keyword>Endoscopy</keyword><keyword>Multicenter Studies</keyword><keyword>Safety</keyword></keywords><dates><year>2008</year></dates><urls><related-urls><url>PM:18355824</url></related-urls></urls></record></Cite></EndNote>[16]. Established Crohn’s disease is an indication for capsule endoscopy with an increased rate of capsule retention. A Swedish analysis found an odds ratio of 9.39 (95%CI: 3.32-26.54, p < 0.001) for capsule retention in patients with known Crohn’s disease compared to bleeding indication ADDIN EN.CITE <EndNote><Cite><Author>Hoog</Author><Year>2012</Year><RecNum>10</RecNum><DisplayText><style face="superscript">[17]</style></DisplayText><record><rec-number>10</rec-number><foreign-keys><key app="EN" db-id="sfzwpaxfafe5tqe2wpepxsr9xzp2ta9wzt9z" timestamp="1470990547">10</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hoog, C. M.</author><author>Bark, L. A.</author><author>Arkani, J.</author><author>Gorsetman, J.</author><author>Brostrom, O.</author><author>Sjoqvist, U.</author></authors></contributors><auth-address>Department of Medicine, Karolinska Institute, Stockholm Soder Hospital, 118 83 Stockholm, Sweden.</auth-address><titles><title>Capsule retentions and incomplete capsule endoscopy examinations: an analysis of 2300 examinations</title><secondary-title>Gastroenterol Res Pract</secondary-title></titles><periodical><full-title>Gastroenterol Res Pract</full-title></periodical><pages>518718</pages><volume>2012</volume><dates><year>2012</year></dates><isbn>1687-630X (Electronic)
1687-6121 (Linking)</isbn><accession-num>21969823</accession-num><urls><related-urls><url>;[17]. Even if current studies could not confirm retention rates of 13% as reported in the era before the advent of the patency capsule ADDIN EN.CITE <EndNote><Cite><Author>Cheifetz</Author><Year>2006</Year><RecNum>385</RecNum><DisplayText><style face="superscript">[18]</style></DisplayText><record><rec-number>385</rec-number><foreign-keys><key app="EN" db-id="90s2awa0haz2tmef0pavsawbr2pwv2wrrxfe" timestamp="1447018811">385</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Cheifetz, A. S.</author><author>Kornbluth, A. A.</author><author>Legnani, P.</author><author>Schmelkin, I.</author><author>Brown, A.</author><author>Lichtiger, S.</author><author>Lewis, B. S.</author></authors></contributors><auth-address>Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA</auth-address><titles><title>The risk of retention of the capsule endoscope in patients with known or suspected Crohn's disease</title><secondary-title>Am.J.Gastroenterol</secondary-title></titles><periodical><full-title>Am.J.Gastroenterol</full-title></periodical><pages>2218-2222</pages><volume>101</volume><number>10</number><reprint-edition>NOT IN FILE</reprint-edition><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>adverse effects</keyword><keyword>Aged</keyword><keyword>Capsule Endoscopes</keyword><keyword>Capsule Endoscopy</keyword><keyword>Capsules</keyword><keyword>Child</keyword><keyword>Cohort Studies</keyword><keyword>complications</keyword><keyword>Crohn Disease</keyword><keyword>Endoscopy</keyword><keyword>epidemiology</keyword><keyword>Female</keyword><keyword>Gastroenterology</keyword><keyword>Humans</keyword><keyword>Intestinal Obstruction</keyword><keyword>Male</keyword><keyword>methods</keyword><keyword>Middle Aged</keyword><keyword>pathology</keyword><keyword>radiography</keyword><keyword>Retrospective Studies</keyword><keyword>Risk Assessment</keyword><keyword>surgery</keyword></keywords><dates><year>2006</year></dates><urls><related-urls><url>PM:16848804</url></related-urls></urls></record></Cite></EndNote>[18], a retention rate of 2%–3% seems to be realistic ADDIN EN.CITE <EndNote><Cite><Author>Nemeth</Author><Year>2016</Year><RecNum>270</RecNum><DisplayText><style face="superscript">[19]</style></DisplayText><record><rec-number>270</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nemeth, A.</author><author>Kopylov, U.</author><author>Koulaouzidis, A.</author><author>Wurm Johansson, G.</author><author>Thorlacius, H.</author><author>Amre, D.</author><author>Eliakim, R.</author><author>Seidman, E. G.</author><author>Toth, E.</author></authors></contributors><auth-address>Department of Gastroenterology, Skane University Hospital, Lund University, Malmo, Sweden.
Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada.
Endoscopy Unit, Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Scotland, United Kingdom.
Department of Gastroenterology, Skane University Hospital, Lund University, Malmo, Sweden.
Department of Surgery, Skane University Hospital, Lund University, Malmo, Sweden.
Research Institute, Saint Justine Medical Center, Universite de Montreal, Montreal, Quebec, Canada.
Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada.
Department of Gastroenterology, Skane University Hospital, Lund University, Malmo, Sweden.</auth-address><titles><title>Use of patency capsule in patients with established Crohn's disease</title><secondary-title>Endoscopy</secondary-title></titles><periodical><full-title>Endoscopy</full-title></periodical><pages>373-9</pages><volume>48</volume><number>4</number><dates><year>2016</year><pub-dates><date>Apr</date></pub-dates></dates><isbn>1438-8812 (Electronic)
0013-726X (Linking)</isbn><accession-num>26561918</accession-num><urls></urls></record></Cite></EndNote>[19]. Clinical assessment, MR-enteroclysis and the use of a patency capsule can help to identify high-risk patients. In a retrospective study 134 patients with known Crohn’s disease underwent VCE. Patients with obstructive symptoms, a history of bowel obstruction and NSAID/aspirin medication were previously excluded and 1/3 had prior small bowel follow through. Although no patency capsule test was performed on this selected group of patients, no cases of a capsule retention were observed ADDIN EN.CITE <EndNote><Cite><Author>Mehdizadeh</Author><Year>2010</Year><RecNum>266</RecNum><DisplayText><style face="superscript">[20]</style></DisplayText><record><rec-number>266</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Mehdizadeh, S.</author><author>Chen, G. C.</author><author>Barkodar, L.</author><author>Enayati, P. J.</author><author>Pirouz, S.</author><author>Yadegari, M.</author><author>Ippoliti, A.</author><author>Vasiliauskas, E. A.</author><author>Lo, S. K.</author><author>Papadakis, K. A.</author></authors></contributors><auth-address>Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.</auth-address><titles><title>Capsule endoscopy in patients with Crohn's disease: diagnostic yield and safety</title><secondary-title>Gastrointest Endosc</secondary-title></titles><periodical><full-title>Gastrointest Endosc</full-title></periodical><pages>121-7</pages><volume>71</volume><number>1</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Capsule Endoscopy</keyword><keyword>Child</keyword><keyword>Crohn Disease/ diagnosis</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Intestine, Small</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Retrospective Studies</keyword><keyword>Treatment Outcome</keyword><keyword>Young Adult</keyword></keywords><dates><year>2010</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>1097-6779 (Electronic)
0016-5107 (Linking)</isbn><accession-num>19863957</accession-num><urls></urls></record></Cite></EndNote>[20]. This is in accordance with a recent retrospective multicenter study including 406 patients with known Crohn’s disease. A patency capsule test in every patient with Crohn’s disease did not show a reduction in the capsule retention rate compared to a selective use of the patency capsule in high risk patients with clinical signs of obstruction, or prior abdominal surgery ADDIN EN.CITE <EndNote><Cite><Author>Nemeth</Author><Year>2016</Year><RecNum>270</RecNum><DisplayText><style face="superscript">[19]</style></DisplayText><record><rec-number>270</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nemeth, A.</author><author>Kopylov, U.</author><author>Koulaouzidis, A.</author><author>Wurm Johansson, G.</author><author>Thorlacius, H.</author><author>Amre, D.</author><author>Eliakim, R.</author><author>Seidman, E. G.</author><author>Toth, E.</author></authors></contributors><auth-address>Department of Gastroenterology, Skane University Hospital, Lund University, Malmo, Sweden.
Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada.
Endoscopy Unit, Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Scotland, United Kingdom.
Department of Gastroenterology, Skane University Hospital, Lund University, Malmo, Sweden.
Department of Surgery, Skane University Hospital, Lund University, Malmo, Sweden.
Research Institute, Saint Justine Medical Center, Universite de Montreal, Montreal, Quebec, Canada.
Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada.
Department of Gastroenterology, Skane University Hospital, Lund University, Malmo, Sweden.</auth-address><titles><title>Use of patency capsule in patients with established Crohn's disease</title><secondary-title>Endoscopy</secondary-title></titles><periodical><full-title>Endoscopy</full-title></periodical><pages>373-9</pages><volume>48</volume><number>4</number><dates><year>2016</year><pub-dates><date>Apr</date></pub-dates></dates><isbn>1438-8812 (Electronic)
0013-726X (Linking)</isbn><accession-num>26561918</accession-num><urls></urls></record></Cite></EndNote>[19]. In a prospective study, 57 patients with known Crohn’s disease and mild symptoms or in remission, who underwent MR-enteroclysis evaluated by two radiologists, had a good sensitivity (92.3% and 100%, respectively) and a negative predictive value (96.3% and 100%, respectively) for retention of the patency capsule as a predictor for functional stenosis test ADDIN EN.CITE <EndNote><Cite><Author>Rozendorn</Author><Year>2016</Year><RecNum>252</RecNum><DisplayText><style face="superscript">[21]</style></DisplayText><record><rec-number>252</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Rozendorn, N.</author><author>Klang, E.</author><author>Lahat, A.</author><author>Yablecovitch, D.</author><author>Kopylov, U.</author><author>Eliakim, A.</author><author>Ben-Horin, S.</author><author>Amitai, M. M.</author></authors></contributors><auth-address>Department of Radiology, Sheba Medical Center, Ramat Gan, Israel.
Department of Radiology, Sheba Medical Center, Ramat Gan, Israel.
Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
Department of Gastroenterology, Sheba Medical Center, Ramat Gan, Israel.
Department of Radiology, Sheba Medical Center, Ramat Gan, Israel.</auth-address><titles><title>Prediction of patency capsule retention in known Crohn's disease patients by using magnetic resonance imaging</title><secondary-title>Gastrointest Endosc</secondary-title></titles><periodical><full-title>Gastrointest Endosc</full-title></periodical><pages>182-7</pages><volume>83</volume><number>1</number><dates><year>2016</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>1097-6779 (Electronic)
0016-5107 (Linking)</isbn><accession-num>26142554</accession-num><urls></urls></record></Cite></EndNote>[21].In 2009 the joint consensus of the Organisation Mondiale d’Endoscopie Digestive and the European Crohn’s and Colitis Organization recommended using imaging techniques before VCE in suspected Crohn’s diseasePEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Cb3VycmVpbGxlPC9BdXRob3I+PFllYXI+MjAwOTwvWWVh
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ADDIN EN.CITE.DATA [23].Patients with a small bowel (SB) tumor seem to have a slightly higher risk of retention. A suspected tumor as an indication for VCE was associated with an odds ratio of 3.9 (95%CI: 1.2-12.8; p = 0.026) ADDIN EN.CITE <EndNote><Cite><Author>Hoog</Author><Year>2012</Year><RecNum>10</RecNum><DisplayText><style face="superscript">[17]</style></DisplayText><record><rec-number>10</rec-number><foreign-keys><key app="EN" db-id="sfzwpaxfafe5tqe2wpepxsr9xzp2ta9wzt9z" timestamp="1470990547">10</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hoog, C. M.</author><author>Bark, L. A.</author><author>Arkani, J.</author><author>Gorsetman, J.</author><author>Brostrom, O.</author><author>Sjoqvist, U.</author></authors></contributors><auth-address>Department of Medicine, Karolinska Institute, Stockholm Soder Hospital, 118 83 Stockholm, Sweden.</auth-address><titles><title>Capsule retentions and incomplete capsule endoscopy examinations: an analysis of 2300 examinations</title><secondary-title>Gastroenterol Res Pract</secondary-title></titles><periodical><full-title>Gastroenterol Res Pract</full-title></periodical><pages>518718</pages><volume>2012</volume><dates><year>2012</year></dates><isbn>1687-630X (Electronic)
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ADDIN EN.CITE.DATA [23]. In sum, suspected or known GI stenosis is a contraindication unless intestinal patency is proven, best by the passage of an intact patency capsule. The risk for capsule retention should be assumed in patients with known Crohn’s disease, clinical or radiologic signs of obstruction, a history of abomino-pelvic radiation, and after small bowel resection. Patients undergoing VCE for mid-GI bleeding without the above risks do not require preceding radiology or a patency capsule.VCE in patients with motility disordersVCE is not indicated for the diagnosis of GI motility disorders. For this purpose, a specifically designed, non-imaging wireless motility capsule (SmartPill, Medtronic plc, Dublin, Ireland) has been developed. Data from sensors measuring pH, pressure, and temperature are transmitted wirelessly for up to 5 days allowing diagnosis of gastroparesis, and prolonged transit times in the small bowel, colon or combined disordersPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Db2xlc2tpPC9BdXRob3I+PFllYXI+MjAxNTwvWWVhcj48
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ADDIN EN.CITE.DATA [24-27].Nevertheless, standard video capsule was applied in 18 patients with chronic intestinal dysmotility in the search for associated mucosal lesions. Three capsules were retained in the stomach for > 2 h, one of them during the entire recording time. However, no permanent retention, symptoms, or need for interventional treatment occurred ADDIN EN.CITE <EndNote><Cite><Author>Hoog</Author><Year>2007</Year><RecNum>1081</RecNum><DisplayText><style face="superscript">[28]</style></DisplayText><record><rec-number>1081</rec-number><foreign-keys><key app="EN" db-id="90s2awa0haz2tmef0pavsawbr2pwv2wrrxfe" timestamp="1447018811">1081</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hoog, C. M.</author><author>Lindberg, G.</author><author>Sjoqvist, U.</author></authors></contributors><auth-address>Stockholm South Hospital, Karolinska Institutet, Stockholm, Sweden. charlotte.hoog@sodersjukhuset.se</auth-address><titles><title>Findings in patients with chronic intestinal dysmotility investigated by capsule endoscopy</title><secondary-title>BMC.Gastroenterol</secondary-title></titles><periodical><full-title>BMC.Gastroenterol</full-title></periodical><pages>29</pages><volume>7</volume><reprint-edition>NOT IN FILE</reprint-edition><keywords><keyword>abnormalities</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Aged,80 and over</keyword><keyword>Capsule Endoscopy</keyword><keyword>Case-Control Studies</keyword><keyword>diagnosis</keyword><keyword>Endoscopy</keyword><keyword>epidemiology</keyword><keyword>Female</keyword><keyword>Gastrointestinal Motility</keyword><keyword>Humans</keyword><keyword>Ileus</keyword><keyword>Intestinal Mucosa</keyword><keyword>Intestine,Small</keyword><keyword>Male</keyword><keyword>methods</keyword><keyword>Middle Aged</keyword><keyword>Prevalence</keyword><keyword>Prospective Studies</keyword><keyword>Stomach</keyword><keyword>Sweden</keyword><keyword>Time</keyword><keyword>Ulcer</keyword></keywords><dates><year>2007</year></dates><urls><related-urls><url>PM:17640373</url></related-urls></urls></record></Cite></EndNote>[28]. Another study included 36 patients with severe symptomatic intestinal motor disorders for analysis of VCE image patterns compared with controls. No adverse events were mentioned in this reportPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5NYWxhZ2VsYWRhPC9BdXRob3I+PFllYXI+MjAwODwvWWVh
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ADDIN EN.CITE.DATA [29]. Although indication of VCE for diagnosis of GI motility disorders has yet to be considered as experimental, known or yet undiagnosed motility disorders may jeopardize routine VCE performed for other indications. Prolonged esophageal or gastric passage may lead to incomplete visualization of the small bowel, i.e. the cecum is not reached during working capacity of the batteries. Moderate prolongation seems to be compensated by longer battery life span in newer capsule generationPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5SYWhtYW48L0F1dGhvcj48WWVhcj4yMDE1PC9ZZWFyPjxS
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ADDIN EN.CITE PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5SYWhtYW48L0F1dGhvcj48WWVhcj4yMDE1PC9ZZWFyPjxS
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PgB=
ADDIN EN.CITE.DATA [30]. VCE systems using an external recorder have the ability to display transmitted images in real-time during the procedurePEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TcGFkYTwvQXV0aG9yPjxZZWFyPjIwMDc8L1llYXI+PFJl
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ADDIN EN.CITE.DATA [31-33]. Significantly prolonged gastric transit time can be identified by this real-time viewer and a prokinetic agent can be administered ADDIN EN.CITE <EndNote><Cite><Author>Lai</Author><Year>2007</Year><RecNum>281</RecNum><DisplayText><style face="superscript">[34]</style></DisplayText><record><rec-number>281</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lai, L. H.</author><author>Wong, G. L.</author><author>Lau, J. Y.</author><author>Sung, J. J.</author><author>Leung, W. K.</author></authors></contributors><auth-address>Institute of Digestive Disease, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.</auth-address><titles><title>Initial experience of real-time capsule endoscopy in monitoring progress of the videocapsule through the upper GI tract</title><secondary-title>Gastrointest Endosc</secondary-title></titles><periodical><full-title>Gastrointest Endosc</full-title></periodical><pages>1211-4</pages><volume>66</volume><number>6</number><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Capsule Endoscopy/ methods</keyword><keyword>Case-Control Studies</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Intestinal Diseases/ diagnosis</keyword><keyword>Intestine, Small/ pathology</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword></keywords><dates><year>2007</year><pub-dates><date>Dec</date></pub-dates></dates><isbn>0016-5107 (Print)
0016-5107 (Linking)</isbn><accession-num>17945224</accession-num><urls></urls></record></Cite></EndNote>[34]. A single center study reported a higher completion rate and diagnostic yield when a real time viewer was used and the capsule was placed endoscopically into the duodenum in the case of prolonged gastric transit time (> 60 min) ADDIN EN.CITE <EndNote><Cite><Author>Gao</Author><Year>2010</Year><RecNum>284</RecNum><DisplayText><style face="superscript">[35]</style></DisplayText><record><rec-number>284</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Gao, Y. J.</author><author>Ge, Z. Z.</author><author>Chen, H. Y.</author><author>Li, X. B.</author><author>Dai, J.</author><author>Ye, C. A.</author><author>Xiao, S. D.</author></authors></contributors><auth-address>Department of Gastroenterology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, People's Republic of China.</auth-address><titles><title>Endoscopic capsule placement improves the completion rate of small-bowel capsule endoscopy and increases diagnostic yield</title><secondary-title>Gastrointest Endosc</secondary-title></titles><periodical><full-title>Gastrointest Endosc</full-title></periodical><pages>103-8</pages><volume>72</volume><number>1</number><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Capsule Endoscopy/ methods</keyword><keyword>Case-Control Studies</keyword><keyword>Diagnosis, Computer-Assisted/ instrumentation</keyword><keyword>Endoscopy, Gastrointestinal</keyword><keyword>Equipment Design</keyword><keyword>Female</keyword><keyword>Gastrointestinal Transit</keyword><keyword>Humans</keyword><keyword>Image Interpretation, Computer-Assisted/ instrumentation</keyword><keyword>Intestinal Diseases/ diagnosis</keyword><keyword>Intestine, Small</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Sensitivity and Specificity</keyword><keyword>Time and Motion Studies</keyword></keywords><dates><year>2010</year><pub-dates><date>Jul</date></pub-dates></dates><isbn>1097-6779 (Electronic)
0016-5107 (Linking)</isbn><accession-num>20304397</accession-num><urls></urls></record></Cite></EndNote>[35]. The unselected primary endoscopic placement of the capsule into the duodenum to circumvent possible gastroparesis had no effect on complete small bowel visualization in a single center analysis of 687 hospitalized or out-patients compared to swallowing the capsule ADDIN EN.CITE <EndNote><Cite><Author>Stanich</Author><Year>2016</Year><RecNum>273</RecNum><DisplayText><style face="superscript">[36]</style></DisplayText><record><rec-number>273</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Stanich, P. P.</author><author>Guido, J.</author><author>Kleinman, B.</author><author>Betkerur, K.</author><author>Porter, K. M.</author><author>Meyer, M. M.</author></authors></contributors><auth-address>Section of Capsule Endoscopy, Division of Gastroenterology, Hepatology & Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States.
Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States.
Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States; Division of Gastroenterology; Einstein Medical Center, Philadelphia, Pennsylvania, United States.
College of Medicine, The Ohio State University, Columbus, Ohio, United States; Department of Internal Medicine, UC Davis School of Medicine, Sacramento, California, United States.
Center for Biostatistics, The Ohio State University, Columbus, Ohio, United States.
Section of Capsule Endoscopy, Division of Gastroenterology, Hepatology & Nutrition, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States.</auth-address><titles><title>Video capsule endoscopy completion and total transit times are similar with oral or endoscopic delivery</title><secondary-title>Endosc Int Open</secondary-title></titles><periodical><full-title>Endosc Int Open</full-title></periodical><pages>E228-32</pages><volume>4</volume><number>2</number><dates><year>2016</year><pub-dates><date>Feb</date></pub-dates></dates><isbn>2364-3722 (Print)
2196-9736 (Linking)</isbn><accession-num>26878055</accession-num><urls></urls></record></Cite></EndNote>[36]. In a prospective single-center study including 100 VCE studies, a pathologic Gastroparesis Cardinal Symptoms Index questionnaire could not predict a prolonged gastric transit time nor did a delayed gastric passage have any clinical significance ADDIN EN.CITE <EndNote><Cite><Author>Carter</Author><Year>2014</Year><RecNum>272</RecNum><DisplayText><style face="superscript">[37]</style></DisplayText><record><rec-number>272</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Carter, D.</author><author>Eliakim, R.</author><author>Har-Noy, O.</author><author>Goldstein, S.</author><author>Derazne, E.</author><author>Bardan, E.</author></authors></contributors><auth-address>aDepartment of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer bSackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.</auth-address><titles><title>PillCam small bowel capsule endoscopy gastric passage interval association with patient's complaints and pathological findings: a prospective study</title><secondary-title>Eur J Gastroenterol Hepatol</secondary-title></titles><periodical><full-title>Eur J Gastroenterol Hepatol</full-title></periodical><pages>47-51</pages><volume>26</volume><number>1</number><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Capsule Endoscopy/ adverse effects/ instrumentation</keyword><keyword>Equipment Design</keyword><keyword>Female</keyword><keyword>Gastrointestinal Transit</keyword><keyword>Gastroparesis/diagnosis/ etiology/physiopathology</keyword><keyword>Humans</keyword><keyword>Intestine, Small/ pathology</keyword><keyword>Israel</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Prospective Studies</keyword><keyword>Risk Factors</keyword><keyword>Surveys and Questionnaires</keyword><keyword>Time Factors</keyword></keywords><dates><year>2014</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>1473-5687 (Electronic)
0954-691X (Linking)</isbn><accession-num>24145864</accession-num><urls></urls></record></Cite></EndNote>[37].GI motility disorders are no contraindication for VCE. The routine use of a real time viewer directly after swallowing the capsule and after an hour enables detection of aspiration (see below) and esophageal or gastric retention and consecutive intervention. VCE in patients with implantable cardiac devicesThe radio transmitters of the first capsule endoscopes work with a carrier frequency of 434.1 MHz in PillCam and 433.8 MHz in EndoCapsule, similar to the C-Net mobile cellular system (450 MHz). The frequency in the newly available OMOM Capsule is 2.4 GHz. Two studies revealed electromagnetic interference (EMI) between cardiac pacemakers (PM) and the C-Net mobile cellular system in 22.4%-30.7% of the tested pacemakersPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Ib2ZnYXJ0bmVyPC9BdXRob3I+PFllYXI+MTk5NjwvWWVh
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ADDIN EN.CITE.DATA [40,41] showing no risk of interference. Nevertheless, users of VCE estimated EMI between capsules and cardiac devices possibly being life-threatening for patients. Since the introduction of VCE, several in vitro and in vivo studies analyzed EMI between VCE (PillCam and EndoCapsule) and PMs (in vitro:PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5CYW5kb3Jza2k8L0F1dGhvcj48WWVhcj4yMDA3PC9ZZWFy
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ADDIN EN.CITE.DATA [43,44] or ICDs in a saline solution with a resistivity corresponding to that of muscle tissue. No interference with any of the PMs was observed. In Dubner’s study in one ICD (Belos DR, Biotronik), interference occurred reproducible when placing a test cap (technical data corresponding to first generation PillCam SB1 video capsule) over the ring and the shock coil electrode, but not over the pulse generator itself. This could still be verified even at 30 cm distance from the ICD system ADDIN EN.CITE <EndNote><Cite><Author>Dubner</Author><Year>2007</Year><RecNum>62</RecNum><DisplayText><style face="superscript">[56]</style></DisplayText><record><rec-number>62</rec-number><foreign-keys><key app="EN" db-id="sfzwpaxfafe5tqe2wpepxsr9xzp2ta9wzt9z" timestamp="1471448371">62</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Dubner, S.</author><author>Dubner, Y.</author><author>Rubio, H.</author><author>Goldin, E.</author></authors></contributors><auth-address>Clinica Suizo Argentina, Argentina. dubner@.ar</auth-address><titles><title>Electromagnetic interference from wireless video-capsule endoscopy on implantable cardioverter-defibrillators</title><secondary-title>Pacing Clin Electrophysiol</secondary-title></titles><periodical><full-title>Pacing Clin Electrophysiol</full-title></periodical><pages>472-5</pages><volume>30</volume><number>4</number><keywords><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Capsule Endoscopy/*adverse effects</keyword><keyword>*Defibrillators, Implantable</keyword><keyword>Electromagnetic Fields</keyword><keyword>Equipment Failure</keyword><keyword>Equipment Safety</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword></keywords><dates><year>2007</year><pub-dates><date>Apr</date></pub-dates></dates><isbn>0147-8389 (Print)
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ADDIN EN.CITE.DATA [69], studies are still warranted. Only one study investigated EMI between the MiroCam endoscope that uses human body communication to transmit data and PMs (n = 3) and ICDs (n = 3)PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5DaHVuZzwvQXV0aG9yPjxZZWFyPjIwMTI8L1llYXI+PFJl
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ADDIN EN.CITE.DATA [70]. VCE was safely performed in patients with PMs and ICDs, and images from capsule endoscopy were not affected by cardiac devices. Studies relating to EMI between OMOM-Capsule and cardiac devices are lacking. For CapsoCam with on board storage of images without transmission, interference with cardiac devices is not possible.EMI between VCE and LVAD was investigated in 10 in-vivo studiesPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5BbW9ybnNhd2Fkd2F0dGFuYTwvQXV0aG9yPjxZZWFyPjIw
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ADDIN EN.CITE.DATA [52,60-68]. No interference was observed in any of the studies.The United States Food and Drug Administration (FDA) and the manufacturers of transmitting capsules (Medtronic GI solutions, Olympus, IntroMedic, and Jinshan) recommend not using VCE in patients with cardiac devices. For CapsoCam without transmission technology there is no such formal contraindication. Guidelines of the ESGE state that VCE is not contraindicated in patients with PM or ICD ADDIN EN.CITE <EndNote><Cite><Author>Ladas</Author><Year>2010</Year><RecNum>64</RecNum><DisplayText><style face="superscript">[71]</style></DisplayText><record><rec-number>64</rec-number><foreign-keys><key app="EN" db-id="sfzwpaxfafe5tqe2wpepxsr9xzp2ta9wzt9z" timestamp="1471448714">64</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ladas, S. D.</author><author>Triantafyllou, K.</author><author>Spada, C.</author><author>Riccioni, M. E.</author><author>Rey, J. F.</author><author>Niv, Y.</author><author>Delvaux, M.</author><author>de Franchis, R.</author><author>Costamagna, G.</author><author>Esge Clinical Guidelines Committee</author></authors></contributors><auth-address>1st and 2nd Departments of Internal Medicine-Propaedeutic, Medical School, University of Athens, Athens, Greece. sdladas@otenet.gr</auth-address><titles><title>European Society of Gastrointestinal Endoscopy (ESGE): recommendations (2009) on clinical use of video capsule endoscopy to investigate small-bowel, esophageal and colonic diseases</title><secondary-title>Endoscopy</secondary-title></titles><periodical><full-title>Endoscopy</full-title></periodical><pages>220-7</pages><volume>42</volume><number>3</number><keywords><keyword>*Capsule Endoscopy</keyword><keyword>Colonic Diseases/diagnosis</keyword><keyword>Esophageal Diseases/diagnosis</keyword><keyword>Europe</keyword><keyword>Gastrointestinal Diseases/*diagnosis</keyword><keyword>Humans</keyword><keyword>Intestine, Small/pathology</keyword><keyword>Societies, Medical</keyword></keywords><dates><year>2010</year><pub-dates><date>Mar</date></pub-dates></dates><isbn>1438-8812 (Electronic)
0013-726X (Linking)</isbn><accession-num>20195992</accession-num><urls><related-urls><url>;[71], whereas the American Society of Gastrointestinal Endoscopy guidelines consider cardiac devices as a relative contraindication for VCE ADDIN EN.CITE <EndNote><Cite><Author>Wang</Author><RecNum>67</RecNum><DisplayText><style face="superscript">[72]</style></DisplayText><record><rec-number>67</rec-number><foreign-keys><key app="EN" db-id="sfzwpaxfafe5tqe2wpepxsr9xzp2ta9wzt9z" timestamp="1471540458">67</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wang, Amy</author><author>Banerjee, Subhas</author><author>Barth, Bradley A.</author><author>Bhat, Yasser M.</author><author>Chauhan, Shailendra</author><author>Gottlieb, Klaus T.</author><author>Konda, Vani</author><author>Maple, John T.</author><author>Murad, Faris</author><author>Pfau, Patrick R.</author><author>Pleskow, Douglas K.</author><author>Siddiqui, Uzma D.</author><author>Tokar, Jeffrey L.</author><author>Rodriguez, Sarah A.</author></authors></contributors><titles><title>Wireless capsule endoscopy</title><secondary-title>Gastrointestinal Endoscopy</secondary-title></titles><periodical><full-title>Gastrointestinal Endoscopy</full-title></periodical><pages>805-815</pages><volume>78</volume><number>6</number><dates></dates><publisher>Elsevier</publisher><isbn>0016-5107</isbn><urls><related-urls><url>;[72]. The German Society of Gastroenterology, Digestive and Metabolic diseases recommends not withholding VCE in patients with a proper indication regardless of implanted cardiac devicesPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5EZW56ZXI8L0F1dGhvcj48WWVhcj4yMDE1PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA [73]. In accordance with the recommendations of the Biotronik and Medtronic Cardio vascular group, VCE can be used in patients with cardiac devices ADDIN EN.CITE <EndNote><Cite><Author>Biotronik</Author><Year>2015</Year><RecNum>311</RecNum><DisplayText><style face="superscript">[74, 75]</style></DisplayText><record><rec-number>311</rec-number><foreign-keys><key app="EN" db-id="t2svzt0tgzw0v3esf5vp9p0zaad5rwv9tdpx" timestamp="1471710243">311</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Biotronik</author></authors></contributors><titles><title>Elektromagnetische Vertr?glichkeit von Herzschrittmachern, ICDs und CRT-Implantaten von BIOTRONIK</title></titles><dates><year>2015</year></dates><pub-location>Berlin, Germany</pub-location><urls><related-urls><url>$FILE/Stoerbeeinflussungen_Implantate_BIOTRONIK.pdf</url></related-urls></urls><electronic-resource-num>$FILE/Stoerbeeinflussungen_Implantate_BIOTRONIK.pdf</electronic-resource-num></record></Cite><Cite><Author>Medtronic</Author><Year>2014</Year><RecNum>310</RecNum><record><rec-number>310</rec-number><foreign-keys><key app="EN" db-id="t2svzt0tgzw0v3esf5vp9p0zaad5rwv9tdpx" timestamp="1471709386">310</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Medtronic</author></authors></contributors><titles><title>Medizinische Verfahren und EMI-Vorsichtsma?nahmen für implantierbare Kardioverter-Defibrillatoren und Defibrillatoren zur kardialen Resynchronisationstherapie, Handbuch für medizinisches Fachpersonal</title></titles><dates><year>2014</year></dates><pub-location>Minneapolis, MN, USA</pub-location><urls><related-urls><url>;[74,75], whereas statements from other manufacturers are not available. Technical data (maximum effective radiated power or output current and transmitter frequency) of VCE (Medtronic, Olympus, Jinshan, IntroMedic) and of the remote transmitting PillCam recorder DR3 were made available to two of the authors (Bandorski D, Stunder D). Based on this data, the maximum electromagnetic radiation in close proximity (5 mm) was calculated for VCE of Medtronic, Olympus, Jinshan as well as for Medtronic recorder DR3. Likewise, for VCE of IntroMedic the maximum obtainable interference voltage at the input of cardiac devices due to the human body communication was evaluated. The determined values are below the safety objectives set by the international product standard for cardiac devices (ISO 14117) ADDIN EN.CITE <EndNote><Cite><Year>2012</Year><RecNum>309</RecNum><DisplayText><style face="superscript">[76]</style></DisplayText><record><rec-number>309</rec-number><foreign-keys><key app="EN" db-id="t2svzt0tgzw0v3esf5vp9p0zaad5rwv9tdpx" timestamp="1471708994">309</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors></contributors><titles><title>International Organization for Standardization (ISO). Active implantable medical devices: electromagnetic compatibility: EMC test protocols for implantable cardiac pacemakers, implantable cardioverter defibrillators and cardiac resynchronization devices. ISO14117-2012</title></titles><dates><year>2012</year></dates><pub-location>Geneva, Switzerland</pub-location><urls></urls><electronic-resource-num>;[76] by a factor of 8 to 85. In conclusion, VCE is safe in patients with PMs/ICDs based on technical data and in vitro/in vivo studies. The automatic frame rate control by transmitting a reverse signal from the recorder (DR3) to the capsule also remains without interference. Technical data of manual remote switching between different image acquisition rates in OMOM capsules are lacking. Wireless telemetry can impair recording of VCE images. Regarding patients with LVAD VCE seems to be safe according to in vivo results. VCE in patients with swallowing disordersCapsule aspiration is a rare complication of VCE with a presumed incidence of 1 in 600-700PEVuZE5vdGU+PENpdGU+PEF1dGhvcj5MdWNlbmRvPC9BdXRob3I+PFllYXI+MjAxMTwvWWVhcj48
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ADDIN EN.CITE.DATA [79] or a barium swallow was uneventful ADDIN EN.CITE <EndNote><Cite><Author>Tabib</Author><Year>2004</Year><RecNum>233</RecNum><DisplayText><style face="superscript">[78]</style></DisplayText><record><rec-number>233</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Tabib, S.</author><author>Fuller, C.</author><author>Daniels, J.</author><author>Lo, S. K.</author></authors></contributors><auth-address>Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.</auth-address><titles><title>Asymptomatic aspiration of a capsule endoscope</title><secondary-title>Gastrointest Endosc</secondary-title></titles><periodical><full-title>Gastrointest Endosc</full-title></periodical><pages>845-8</pages><volume>60</volume><number>5</number><keywords><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Bronchi</keyword><keyword>Endoscopes, Gastrointestinal/adverse effects</keyword><keyword>Endoscopy, Gastrointestinal/ adverse effects/methods</keyword><keyword>Foreign Bodies/etiology/ radiography</keyword><keyword>Humans</keyword><keyword>Inhalation</keyword><keyword>Male</keyword></keywords><dates><year>2004</year><pub-dates><date>Nov</date></pub-dates></dates><isbn>0016-5107 (Print)
0016-5107 (Linking)</isbn><accession-num>15557975</accession-num><urls></urls></record></Cite></EndNote>[78]. In a series of 15 well-documented cases of capsule aspiration, only three patients had a history of dysphagia. The leading symptom during the aspiration was coughing (12/15) ADDIN EN.CITE <EndNote><Cite><Author>Amarna</Author><Year>2015</Year><RecNum>282</RecNum><DisplayText><style face="superscript">[80]</style></DisplayText><record><rec-number>282</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Amarna, M.</author><author>Vanlandingham, A.</author><author>Brahmbhatt, P.</author><author>Roy, T. M.</author><author>Byrd, R. P., Jr.</author></authors></contributors><auth-address>Division of Pulmonary Diseases and Critical Care Medicine, East Tennessee State University, Johnson City, Tennessee, United States.
Department of Internal Medicine, The James H. Quillen VAMC, Mountain Home, Tennessee, United States.
Department of Internal Medicine, The James H. Quillen VAMC, Mountain Home, Tennessee, United States.
Division of Pulmonary Diseases and Critical Care Medicine, East Tennessee State University, Johnson City, Tennessee, United States.
Division of Pulmonary Diseases and Critical Care Medicine, East Tennessee State University, Johnson City, Tennessee, United States.</auth-address><titles><title>Late presentation of capsule endoscope aspiration with successful extraction by flexible bronchoscopy utilizing a snare wire loop</title><secondary-title>Endoscopy</secondary-title></titles><periodical><full-title>Endoscopy</full-title></periodical><pages>E6-7</pages><volume>47 Suppl 1 UCTN</volume><keywords><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Bronchoscopy/instrumentation</keyword><keyword>Capsule Endoscopy/ adverse effects</keyword><keyword>Delayed Diagnosis</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Respiratory Aspiration/ diagnosis/etiology/ therapy</keyword></keywords><dates><year>2015</year></dates><isbn>1438-8812 (Electronic)
0013-726X (Linking)</isbn><accession-num>25603524</accession-num><urls></urls></record></Cite></EndNote>[80], which can stop even if the capsule is still within the trachea ADDIN EN.CITE <EndNote><Cite><Author>Juanmartinena Fernandez</Author><Year>2016</Year><RecNum>259</RecNum><DisplayText><style face="superscript">[81]</style></DisplayText><record><rec-number>259</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Juanmartinena Fernandez, J. F.</author><author>Fernandez-Urien, I.</author><author>Vila Costas, J. J.</author></authors></contributors><auth-address>Unidad de Endoscopia. Aparato Digestivo, Complejo Hospitalario de Navarra, espana.
Digestivo, Complejo Hospitalario de Navarra, Espana.
S masculine Digestivo A, Complejo Hospitalario de Navarra, Espana.</auth-address><titles><title>Asymptomatic bronchial aspiration of capsule endoscope: a significant complication</title><secondary-title>Rev Esp Enferm Dig</secondary-title></titles><periodical><full-title>Rev Esp Enferm Dig</full-title></periodical><dates><year>2016</year><pub-dates><date>Apr 29</date></pub-dates></dates><isbn>1130-0108 (Electronic)
1130-0108 (Linking)</isbn><accession-num>27128495</accession-num><urls></urls></record></Cite></EndNote>[81]. The aspiration resolved spontaneously by coughing (9/15) or via endoscopic retrieval (6/15) ADDIN EN.CITE <EndNote><Cite><Author>Amarna</Author><Year>2015</Year><RecNum>282</RecNum><DisplayText><style face="superscript">[80]</style></DisplayText><record><rec-number>282</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Amarna, M.</author><author>Vanlandingham, A.</author><author>Brahmbhatt, P.</author><author>Roy, T. M.</author><author>Byrd, R. P., Jr.</author></authors></contributors><auth-address>Division of Pulmonary Diseases and Critical Care Medicine, East Tennessee State University, Johnson City, Tennessee, United States.
Department of Internal Medicine, The James H. Quillen VAMC, Mountain Home, Tennessee, United States.
Department of Internal Medicine, The James H. Quillen VAMC, Mountain Home, Tennessee, United States.
Division of Pulmonary Diseases and Critical Care Medicine, East Tennessee State University, Johnson City, Tennessee, United States.
Division of Pulmonary Diseases and Critical Care Medicine, East Tennessee State University, Johnson City, Tennessee, United States.</auth-address><titles><title>Late presentation of capsule endoscope aspiration with successful extraction by flexible bronchoscopy utilizing a snare wire loop</title><secondary-title>Endoscopy</secondary-title></titles><periodical><full-title>Endoscopy</full-title></periodical><pages>E6-7</pages><volume>47 Suppl 1 UCTN</volume><keywords><keyword>Aged</keyword><keyword>Aged, 80 and over</keyword><keyword>Bronchoscopy/instrumentation</keyword><keyword>Capsule Endoscopy/ adverse effects</keyword><keyword>Delayed Diagnosis</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Respiratory Aspiration/ diagnosis/etiology/ therapy</keyword></keywords><dates><year>2015</year></dates><isbn>1438-8812 (Electronic)
0013-726X (Linking)</isbn><accession-num>25603524</accession-num><urls></urls></record></Cite></EndNote>[80]. In one case, asymptomatic retention of a capsule for 6 days within in a bronchus and consecutive spontaneous passage through the GI tract was reported ADDIN EN.CITE <EndNote><Cite><Author>Pezzoli</Author><Year>2016</Year><RecNum>2940</RecNum><DisplayText><style face="superscript">[82]</style></DisplayText><record><rec-number>2940</rec-number><foreign-keys><key app="EN" db-id="90s2awa0haz2tmef0pavsawbr2pwv2wrrxfe" timestamp="1471722455">2940</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Pezzoli, A.</author><author>Fusetti, N.</author><author>Pizzo, E.</author></authors></contributors><auth-address>Department of Gastroenterology, Endoscopy Unit, Sant'Anna Hospital Ferrara, Ferrara, Italy.
Department of Applied Health Research, University College London, London, United Kingdom.</auth-address><titles><title>Capsule endoscopy diagnosis of intestinal Taenia</title><secondary-title>Gastrointest Endosc</secondary-title></titles><periodical><full-title>Gastrointest Endosc</full-title></periodical><pages>261-2</pages><volume>83</volume><number>1</number><dates><year>2016</year><pub-dates><date>Jan</date></pub-dates></dates><isbn>1097-6779 (Electronic)
0016-5107 (Linking)</isbn><accession-num>26320694</accession-num><urls><related-urls><url>;[82]. However, one patient with capsule aspiration experienced fatal extensive intracerebral hemorrhage, either provoked by initial coughing or during consecutive endoscopy for retrieval ADDIN EN.CITE <EndNote><Cite><Author>Parker</Author><Year>2012</Year><RecNum>286</RecNum><DisplayText><style face="superscript">[83]</style></DisplayText><record><rec-number>286</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Parker, C.</author><author>Davison, C.</author><author>Panter, S.</author></authors></contributors><titles><title>Tracheal aspiration of a capsule endoscope: not always a benign event</title><secondary-title>Dig Dis Sci</secondary-title></titles><periodical><full-title>Dig Dis Sci</full-title></periodical><pages>1727-8</pages><volume>57</volume><number>6</number><keywords><keyword>Capsule Endoscopes/ adverse effects</keyword><keyword>Capsule Endoscopy/ adverse effects</keyword><keyword>Device Removal</keyword><keyword>Humans</keyword><keyword>Male</keyword><keyword>Respiratory Aspiration/ etiology</keyword></keywords><dates><year>2012</year><pub-dates><date>Jun</date></pub-dates></dates><isbn>1573-2568 (Electronic)
0163-2116 (Linking)</isbn><accession-num>22526588</accession-num><urls></urls></record></Cite></EndNote>[83].In case of an increased risk of aspiration, the capsule should be placed endoscopically directly into the duodenumPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5EZW56ZXI8L0F1dGhvcj48WWVhcj4yMDE1PC9ZZWFyPjxS
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ADDIN EN.CITE.DATA [73]. This can be achieved via an overtube ADDIN EN.CITE <EndNote><Cite><Author>Ito</Author><Year>2016</Year><RecNum>283</RecNum><DisplayText><style face="superscript">[84]</style></DisplayText><record><rec-number>283</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ito, S.</author><author>Hotta, K.</author><author>Imai, K.</author><author>Ono, H.</author></authors></contributors><auth-address>Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.
Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.
Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.
Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan.</auth-address><titles><title>Overtube-assisted placement of a capsule endoscope in a patient with a swallowing disorder</title><secondary-title>Endoscopy</secondary-title></titles><periodical><full-title>Endoscopy</full-title></periodical><pages>E47-8</pages><volume>48 Suppl 1 UCTN</volume><dates><year>2016</year></dates><isbn>1438-8812 (Electronic)
0013-726X (Linking)</isbn><accession-num>26829201</accession-num><urls></urls></record></Cite></EndNote>[84] or a special endoscopic delivery device (AdvanCE, US Endoscopy, Mentor, Oh, United States) ADDIN EN.CITE <EndNote><Cite><Author>Holden</Author><Year>2007</Year><RecNum>287</RecNum><DisplayText><style face="superscript">[85]</style></DisplayText><record><rec-number>287</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Holden, J. P.</author><author>Dureja, P.</author><author>Pfau, P. R.</author><author>Schwartz, D. C.</author><author>Reichelderfer, M.</author><author>Judd, R. H.</author><author>Danko, I.</author><author>Iyer, L. V.</author><author>Gopal, D. V.</author></authors></contributors><auth-address>Section of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin 53792-5124, USA.</auth-address><titles><title>Endoscopic placement of the small-bowel video capsule by using a capsule endoscope delivery device</title><secondary-title>Gastrointest Endosc</secondary-title></titles><periodical><full-title>Gastrointest Endosc</full-title></periodical><pages>842-7</pages><volume>65</volume><number>6</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Aged</keyword><keyword>Capsule Endoscopes</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>Deglutition Disorders/ diagnosis/ therapy</keyword><keyword>Endoscopes, Gastrointestinal</keyword><keyword>Endoscopy, Gastrointestinal/ methods</keyword><keyword>Equipment Design</keyword><keyword>Equipment Safety</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Intestinal Neoplasms/ diagnosis</keyword><keyword>Intestine, Small/ pathology</keyword><keyword>Male</keyword><keyword>Middle Aged</keyword><keyword>Retrospective Studies</keyword><keyword>Video Recording</keyword></keywords><dates><year>2007</year><pub-dates><date>May</date></pub-dates></dates><isbn>0016-5107 (Print)
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ADDIN EN.CITE.DATA [86].In conclusion, swallowing disorders with the inability to safely swallow the capsule are a contraindication for standard procedure. However, if endoscopic placement is applied, VCE can be safely performed. The clinical challenge is the identification of patients at risk. Older patients, a history of cerebral stroke, bleeding or trauma, require a thorough history, and test for swallowing function. Children may have a test with swallowing a marshmallow.VCE in pregnancyDuring pregnancy the growing uterus compresses the GI tract. Additionally, gastrointestinal transit is prolonged in the second and third trimester ADDIN EN.CITE <EndNote><Cite><Author>Lawson</Author><Year>1985</Year><RecNum>3080</RecNum><DisplayText><style face="superscript">[87]</style></DisplayText><record><rec-number>3080</rec-number><foreign-keys><key app="EN" db-id="90s2awa0haz2tmef0pavsawbr2pwv2wrrxfe" timestamp="1468784776">3080</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Lawson, M.</author><author>Kern, F., Jr.</author><author>Everson, G. T.</author></authors></contributors><titles><title>Gastrointestinal transit time in human pregnancy: prolongation in the second and third trimesters followed by postpartum normalization</title><secondary-title>Gastroenterology</secondary-title></titles><periodical><full-title>Gastroenterology</full-title></periodical><pages>996-9</pages><volume>89</volume><number>5</number><keywords><keyword>Adolescent</keyword><keyword>Adult</keyword><keyword>Breath Tests</keyword><keyword>*Digestive System Physiological Phenomena</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Lactulose/metabolism</keyword><keyword>Postpartum Period</keyword><keyword>*Pregnancy</keyword><keyword>Pregnancy Trimester, Second</keyword><keyword>Pregnancy Trimester, Third</keyword><keyword>Progesterone/blood</keyword><keyword>Time Factors</keyword></keywords><dates><year>1985</year><pub-dates><date>Nov</date></pub-dates></dates><isbn>0016-5085 (Print)
0016-5085 (Linking)</isbn><accession-num>4043680</accession-num><urls><related-urls><url>;[87], which theoretically may jeopardize VCE procedure. There are only two published cases of VCE studies about pregnant women. Both reported no adverse events including no retention. The first case was a 30-year-old woman with extensive GI bleeding. A conventional upper endoscopy was uneventful. Lower endoscopy showed fresh blood coming out of the ileocecal valve. VCE revealed an ulcerated jejunal neuroendocrine tumor. Emergency surgery was successful and mother and child were alive and well ADDIN EN.CITE <EndNote><Cite><Author>Hogan</Author><Year>2007</Year><RecNum>237</RecNum><DisplayText><style face="superscript">[88]</style></DisplayText><record><rec-number>237</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Hogan, R. B.</author><author>Ahmad, N.</author><author>Hogan, R. B., 3rd</author><author>Hensley, S. D.</author><author>Phillips, P.</author><author>Doolittle, P.</author><author>Reimund, E.</author></authors></contributors><auth-address>Gastrointestinal Associates, Jackson, Mississippi 39202, USA.</auth-address><titles><title>Video capsule endoscopy detection of jejunal carcinoid in life-threatening hemorrhage, first trimester pregnancy</title><secondary-title>Gastrointest Endosc</secondary-title></titles><periodical><full-title>Gastrointest Endosc</full-title></periodical><pages>205-7</pages><volume>66</volume><number>1</number><keywords><keyword>Adult</keyword><keyword>Capsule Endoscopy</keyword><keyword>Carcinoid Tumor/ pathology/surgery</keyword><keyword>Female</keyword><keyword>Gastrointestinal Hemorrhage/ etiology/surgery</keyword><keyword>Humans</keyword><keyword>Jejunal Neoplasms/ pathology/surgery</keyword><keyword>Pregnancy</keyword><keyword>Pregnancy Complications, Neoplastic/ pathology/surgery</keyword><keyword>Pregnancy Trimester, First</keyword></keywords><dates><year>2007</year><pub-dates><date>Jul</date></pub-dates></dates><isbn>0016-5107 (Print)
0016-5107 (Linking)</isbn><accession-num>17521645</accession-num><urls></urls></record></Cite></EndNote>[88]. The second case was a 20-year-old woman with a history of cavernous transformation of the portal vein with secondary thrombosis after omphalitis at the age of two. Esophageal varices were treated with sclerotherapy and banding at age 13 and 15. Due to the high risk of upper GI bleeding during pregnancy, the esophagus was examined through the PillCam ESO capsule. No esophageal or gastric varices were detected. The VCE study was uneventful with mother and child alive and well ADDIN EN.CITE <EndNote><Cite><Author>Wax</Author><Year>2006</Year><RecNum>241</RecNum><DisplayText><style face="superscript">[89]</style></DisplayText><record><rec-number>241</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Wax, J. R.</author><author>Pinette, M. G.</author><author>Cartin, A.</author><author>Winn, S. S.</author><author>Blackstone, J.</author></authors></contributors><auth-address>Division of Maternal & Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME 04102, USA. waxj@</auth-address><titles><title>Cavernous transformation of the portal vein complicating pregnancy</title><secondary-title>Obstet Gynecol</secondary-title></titles><periodical><full-title>Obstet Gynecol</full-title></periodical><pages>782-4</pages><volume>108</volume><number>3 Pt 2</number><keywords><keyword>Adult</keyword><keyword>Cesarean Section</keyword><keyword>Endoscopy, Digestive System</keyword><keyword>Esophageal and Gastric Varices/complications</keyword><keyword>Female</keyword><keyword>Gestational Age</keyword><keyword>Humans</keyword><keyword>Hypersplenism/complications</keyword><keyword>Hypertension, Portal/complications</keyword><keyword>Medline</keyword><keyword>Magnetic Resonance Imaging</keyword><keyword>Portal Vein/ abnormalities</keyword><keyword>Pregnancy</keyword><keyword>Pregnancy Complications, Cardiovascular/ diagnosis</keyword><keyword>Thrombocytopenia/complications</keyword><keyword>Umbilical Cord</keyword><keyword>Venous Thrombosis/complications</keyword></keywords><dates><year>2006</year><pub-dates><date>Sep</date></pub-dates></dates><isbn>0029-7844 (Print)
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ADDIN EN.CITE.DATA [90]. In contrast, pregnancies of mothers reporting microwave use 6 months prior to the pregnancy or during the first trimester were more likely to result in miscarriage (OR = 1.28, 95%CI: 1.02-1.59). The odds ratio was raised with an increasing level of exposure with an odds ratio of 1.59 for the highest exposure group (20 or more exposures/month) ADDIN EN.CITE <EndNote><Cite><Author>Ouellet-Hellstrom</Author><Year>1993</Year><RecNum>3083</RecNum><DisplayText><style face="superscript">[91]</style></DisplayText><record><rec-number>3083</rec-number><foreign-keys><key app="EN" db-id="90s2awa0haz2tmef0pavsawbr2pwv2wrrxfe" timestamp="1468786546">3083</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Ouellet-Hellstrom, R.</author><author>Stewart, W. F.</author></authors></contributors><titles><title>Miscarriages among female physical therapists who report using radio- and microwave-frequency electromagnetic radiation</title><secondary-title>Am J Epidemiol</secondary-title></titles><periodical><full-title>Am J Epidemiol</full-title></periodical><pages>775-86</pages><volume>138</volume><number>10</number><keywords><keyword>Abortion, Spontaneous/*epidemiology/etiology</keyword><keyword>Adult</keyword><keyword>Case-Control Studies</keyword><keyword>Diathermy</keyword><keyword>Female</keyword><keyword>Humans</keyword><keyword>Microwaves/*adverse effects</keyword><keyword>Middle Aged</keyword><keyword>Occupational Exposure/*adverse effects</keyword><keyword>Odds Ratio</keyword><keyword>*Physical Therapy Modalities</keyword><keyword>Pregnancy</keyword><keyword>Radio Waves/*adverse effects</keyword><keyword>Risk Factors</keyword></keywords><dates><year>1993</year><pub-dates><date>Nov 15</date></pub-dates></dates><isbn>0002-9262 (Print)
0002-9262 (Linking)</isbn><accession-num>8237966</accession-num><urls><related-urls><url>;[91]. Although microwaves have a higher frequency — from 300 to 3000 MHz — than radio waves, the radio waves used by endoscopic capsules (e.g., 434 MHz for PillCam and EndoCapsule) are within the lower range of microwaves. Another comparator are effects caused by mobile phones with a much higher power than video capsules but not reaching proximity to the unborn as an intra-abdominal source of radio waves. This risk is not relevant for CapsoCam without electro-magnetic emission.In conclusion, elective capsule endoscopy should be postponed after delivery due to missing data. Nevertheless, VCE may be considered in indications related to maternal symptoms not allowing delay of diagnosis as in relevant small bowel bleeding. Accordingly, the FDA assesses pregnancy only as a relative contraindication to VCE ADDIN EN.CITE <EndNote><Cite><Author>Savas</Author><Year>2014</Year><RecNum>238</RecNum><DisplayText><style face="superscript">[92]</style></DisplayText><record><rec-number>238</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Savas, N.</author></authors></contributors><auth-address>Nurten Savas, Department of Gastroenterology, Baskent Universitesi Hastanesi, 06990 Istanbul, Turkey.</auth-address><titles><title>Gastrointestinal endoscopy in pregnancy</title><secondary-title>World J Gastroenterol</secondary-title></titles><periodical><full-title>World J Gastroenterol</full-title></periodical><pages>15241-52</pages><volume>20</volume><number>41</number><keywords><keyword>Analgesics/adverse effects</keyword><keyword>Cholangiopancreatography, Endoscopic Retrograde/adverse effects</keyword><keyword>Digestive System Diseases/ diagnosis/ therapy</keyword><keyword>Endoscopy, Gastrointestinal/adverse effects</keyword><keyword>Endosonography/adverse effects</keyword><keyword>Female</keyword><keyword>Fetus/drug effects</keyword><keyword>Humans</keyword><keyword>Hypnotics and Sedatives/adverse effects</keyword><keyword>Patient Selection</keyword><keyword>Predictive Value of Tests</keyword><keyword>Pregnancy</keyword><keyword>Pregnancy Complications/ diagnosis/ therapy</keyword><keyword>Prenatal Injuries/etiology</keyword><keyword>Risk Assessment</keyword><keyword>Risk Factors</keyword><keyword>Treatment Outcome</keyword><keyword>Ultrasonography, Prenatal/adverse effects/ methods</keyword><keyword>Colonoscopy</keyword><keyword>Endoscopic retrograde cholangiopancreatography</keyword><keyword>Endoscopy</keyword><keyword>Pregnancy</keyword><keyword>Safety</keyword></keywords><dates><year>2014</year><pub-dates><date>Nov 7</date></pub-dates></dates><isbn>2219-2840 (Electronic)
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ADDIN EN.CITE.DATA [93]. The main issue of VCE in children seems to be the ability to voluntarily swallow the capsule and the fear of the capsule not being able to pass the narrow GI tract ADDIN EN.CITE <EndNote><Cite><Author>Arguelles Arias</Author><Year>2015</Year><RecNum>243</RecNum><DisplayText><style face="superscript">[94]</style></DisplayText><record><rec-number>243</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Arguelles Arias, F.</author><author>Donat, E.</author><author>Fernandez-Urien, I.</author><author>Alberca, F.</author><author>Arguelles-Martin, F.</author><author>Martinez, M. J.</author><author>Molina, M.</author><author>Varea, V.</author><author>Herrerias Gutierrez, J. M.</author><author>Ribes-Koninckx, C.</author></authors></contributors><auth-address>Digestivo, H. Universitarioa Virgen Macarena, Espana.
Pediatria, Hospital la Fe, Valencia, Espana.
Digestivo, Complejo Hospitalario de Navarra, Espana.
DIGESTIVO/ENDOSCOPIAS, Hospital Universitario Virgen de la Arrixaca. Murcia, Espana.
Pediatria, Hospital Universitario Virgen Macarena, Espana.
Pediatria, Hospital Nino Jesus, Espana.
Pediatria, Hospital La Paz, Espana.
Pediatria, Hospital San Joan de Deu, Espana.
Aparato Digestivo, Hospital Universitario Virgen Macarena, Espana.
Pediatria, Hospital la Fe, Espana.</auth-address><titles><title>Guideline for wireless capsule endoscopy in children and adolescents: A consensus document by the SEGHNP (Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition) and the SEPD (Spanish Society for Digestive Diseases)</title><secondary-title>Rev Esp Enferm Dig</secondary-title></titles><periodical><full-title>Rev Esp Enferm Dig</full-title></periodical><pages>714-31</pages><volume>107</volume><number>12</number><dates><year>2015</year><pub-dates><date>Dec</date></pub-dates></dates><isbn>1130-0108 (Print)
1130-0108 (Linking)</isbn><accession-num>26671584</accession-num><urls></urls></record></Cite></EndNote>[94]. Since it was introduced, the minimum age of VCE has been lowered by the manufacturers and the FDA. In 2009 the FDA approved VCE for children of 2 years or older. The youngest age of a child undergoing a VCE study was 8 mo ADDIN EN.CITE <EndNote><Cite><Author>Nuutinen</Author><Year>2011</Year><RecNum>246</RecNum><DisplayText><style face="superscript">[95]</style></DisplayText><record><rec-number>246</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Nuutinen, H.</author><author>Kolho, K. L.</author><author>Salminen, P.</author><author>Rintala, R.</author><author>Koskenpato, J.</author><author>Koivusalo, A.</author><author>Sipponen, T.</author><author>Farkkila, M.</author></authors></contributors><auth-address>Clinic of Gastroenterology, Helsinki University Central Hospital, University of Helsinki, Finland. hannu.nuutinen@hus.fi</auth-address><titles><title>Capsule endoscopy in pediatric patients: technique and results in our first 100 consecutive children</title><secondary-title>Scand J Gastroenterol</secondary-title></titles><periodical><full-title>Scand J Gastroenterol</full-title></periodical><pages>1138-43</pages><volume>46</volume><number>9</number><keywords><keyword>Abdominal Pain/etiology</keyword><keyword>Adolescent</keyword><keyword>Capsule Endoscopy/adverse effects</keyword><keyword>Child</keyword><keyword>Child, Preschool</keyword><keyword>Colitis, Ulcerative/ diagnosis</keyword><keyword>Crohn Disease/ diagnosis</keyword><keyword>Diarrhea/etiology</keyword><keyword>Female</keyword><keyword>Gastrointestinal Hemorrhage/diagnosis/ etiology</keyword><keyword>Gastrointestinal Transit</keyword><keyword>Humans</keyword><keyword>Infant</keyword><keyword>Male</keyword><keyword>Nausea/etiology</keyword><keyword>Retrospective Studies</keyword></keywords><dates><year>2011</year><pub-dates><date>Sep</date></pub-dates></dates><isbn>1502-7708 (Electronic)
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ADDIN EN.CITE.DATA [96]. Voluntary ingestion seems feasible at an age older than 6-8 years ADDIN EN.CITE <EndNote><Cite><Author>Arguelles Arias</Author><Year>2015</Year><RecNum>243</RecNum><DisplayText><style face="superscript">[94]</style></DisplayText><record><rec-number>243</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Arguelles Arias, F.</author><author>Donat, E.</author><author>Fernandez-Urien, I.</author><author>Alberca, F.</author><author>Arguelles-Martin, F.</author><author>Martinez, M. J.</author><author>Molina, M.</author><author>Varea, V.</author><author>Herrerias Gutierrez, J. M.</author><author>Ribes-Koninckx, C.</author></authors></contributors><auth-address>Digestivo, H. Universitarioa Virgen Macarena, Espana.
Pediatria, Hospital la Fe, Valencia, Espana.
Digestivo, Complejo Hospitalario de Navarra, Espana.
DIGESTIVO/ENDOSCOPIAS, Hospital Universitario Virgen de la Arrixaca. Murcia, Espana.
Pediatria, Hospital Universitario Virgen Macarena, Espana.
Pediatria, Hospital Nino Jesus, Espana.
Pediatria, Hospital La Paz, Espana.
Pediatria, Hospital San Joan de Deu, Espana.
Aparato Digestivo, Hospital Universitario Virgen Macarena, Espana.
Pediatria, Hospital la Fe, Espana.</auth-address><titles><title>Guideline for wireless capsule endoscopy in children and adolescents: A consensus document by the SEGHNP (Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition) and the SEPD (Spanish Society for Digestive Diseases)</title><secondary-title>Rev Esp Enferm Dig</secondary-title></titles><periodical><full-title>Rev Esp Enferm Dig</full-title></periodical><pages>714-31</pages><volume>107</volume><number>12</number><dates><year>2015</year><pub-dates><date>Dec</date></pub-dates></dates><isbn>1130-0108 (Print)
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ADDIN EN.CITE.DATA [86]. However, the manufacturer of PillCam recommends not letting children under the age of 8 years swallow the capsule. If endoscopic delivery is necessary, the AdvanCE delivery device was superior to the Roth-net, which caused significant mucosal trauma in 50% in a multicenter trialPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Gcml0c2NoZXItUmF2ZW5zPC9BdXRob3I+PFllYXI+MjAw
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ADDIN EN.CITE.DATA [86].There have been no reports of a capsule aspiration, perforation or complete small bowel obstruction in the studies and meta-analyses of more than 1000 VCE studies with childrenPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5Db2hlbjwvQXV0aG9yPjxZZWFyPjIwMTI8L1llYXI+PFJl
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ADDIN EN.CITE.DATA [86,93,95-98]. In the largest meta-analysis, the retention rate was 2.3%. The risk for retention was higher in known inflammatory bowel disease (IBD; 5.2%), a small bowel follow through suggestive of Crohn’s disease (CD 35.7%), and the combination of a body-mass-index below the 5th percentile and known IBD (43%). Retention rates by indication were 1.2% for OGIB, 2.6% for CD, and 2.1% for neoplastic lesionsPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5PbGl2YTwvQXV0aG9yPjxZZWFyPjIwMTQ8L1llYXI+PFJl
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ADDIN EN.CITE.DATA [97,98]. Guidelines of the Spanish Societies for Pediatric Gastroenterology, Hepatology, and Nutrition (SEGHNP) and for Digestive Diseases (SEPD) recommend that in suspected or established Crohn’s disease, magnetic resonance enterography or patency capsule should precede VCE in cases of obstruction symptoms ADDIN EN.CITE <EndNote><Cite><Author>Arguelles Arias</Author><Year>2015</Year><RecNum>243</RecNum><DisplayText><style face="superscript">[94]</style></DisplayText><record><rec-number>243</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Arguelles Arias, F.</author><author>Donat, E.</author><author>Fernandez-Urien, I.</author><author>Alberca, F.</author><author>Arguelles-Martin, F.</author><author>Martinez, M. J.</author><author>Molina, M.</author><author>Varea, V.</author><author>Herrerias Gutierrez, J. M.</author><author>Ribes-Koninckx, C.</author></authors></contributors><auth-address>Digestivo, H. Universitarioa Virgen Macarena, Espana.
Pediatria, Hospital la Fe, Valencia, Espana.
Digestivo, Complejo Hospitalario de Navarra, Espana.
DIGESTIVO/ENDOSCOPIAS, Hospital Universitario Virgen de la Arrixaca. Murcia, Espana.
Pediatria, Hospital Universitario Virgen Macarena, Espana.
Pediatria, Hospital Nino Jesus, Espana.
Pediatria, Hospital La Paz, Espana.
Pediatria, Hospital San Joan de Deu, Espana.
Aparato Digestivo, Hospital Universitario Virgen Macarena, Espana.
Pediatria, Hospital la Fe, Espana.</auth-address><titles><title>Guideline for wireless capsule endoscopy in children and adolescents: A consensus document by the SEGHNP (Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition) and the SEPD (Spanish Society for Digestive Diseases)</title><secondary-title>Rev Esp Enferm Dig</secondary-title></titles><periodical><full-title>Rev Esp Enferm Dig</full-title></periodical><pages>714-31</pages><volume>107</volume><number>12</number><dates><year>2015</year><pub-dates><date>Dec</date></pub-dates></dates><isbn>1130-0108 (Print)
1130-0108 (Linking)</isbn><accession-num>26671584</accession-num><urls></urls></record></Cite></EndNote>[94].Magnetic resonance imaging in patients with incorporated capsuleAs no testing on magnetic resonance (MR) compatibility of VCEs has been conducted, the FDA requested a warning that a patient should not undergo magnetic resonance imaging (MRI) until excretion of the capsule has been verified ADDIN EN.CITE <EndNote><Cite><Year>2012</Year><RecNum>2941</RecNum><DisplayText><style face="superscript">[99]</style></DisplayText><record><rec-number>2941</rec-number><foreign-keys><key app="EN" db-id="90s2awa0haz2tmef0pavsawbr2pwv2wrrxfe" timestamp="1471800909">2941</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors></contributors><titles><title>US Food and Drug Administration (FDA). De novo classification request for PillCam Colon 2 capsule endoscsopy system</title></titles><dates><year>2012</year></dates><urls></urls><electronic-resource-num>;[99]. The feared theoretical complication of performing an MRI scan while a capsule is still within the GI tract is migration of the capsule and the potential for bowel injury or perforation due to heat or high forces ADDIN EN.CITE <EndNote><Cite><Author>Anderson</Author><Year>2013</Year><RecNum>105</RecNum><DisplayText><style face="superscript">[100]</style></DisplayText><record><rec-number>105</rec-number><foreign-keys><key app="EN" db-id="sfzwpaxfafe5tqe2wpepxsr9xzp2ta9wzt9z" timestamp="1472020553">105</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Anderson, B. W.</author><author>Liang, J. J.</author><author>Dejesus, R. S.</author></authors></contributors><auth-address>Department of Medicine, Mayo Clinic, Rochester, MN.</auth-address><titles><title>Capsule endoscopy device retention and magnetic resonance imaging</title><secondary-title>Proc (Bayl Univ Med Cent)</secondary-title></titles><periodical><full-title>Proc (Bayl Univ Med Cent)</full-title></periodical><pages>270-1</pages><volume>26</volume><number>3</number><dates><year>2013</year><pub-dates><date>Jul</date></pub-dates></dates><isbn>0899-8280 (Print)
0899-8280 (Linking)</isbn><accession-num>23814387</accession-num><urls><related-urls><url>;[100]. There are only few reported cases of MRI scans in patients with retained video capsules. In one case, an emergency MRI of the lumbar spine was ordered due to acute lumbar radiculopathy. The localizing sequence showed a focal susceptibility and the MRI was terminated, the capsule was excreted two days later ADDIN EN.CITE <EndNote><Cite><Author>Anderson</Author><Year>2013</Year><RecNum>105</RecNum><DisplayText><style face="superscript">[100]</style></DisplayText><record><rec-number>105</rec-number><foreign-keys><key app="EN" db-id="sfzwpaxfafe5tqe2wpepxsr9xzp2ta9wzt9z" timestamp="1472020553">105</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Anderson, B. W.</author><author>Liang, J. J.</author><author>Dejesus, R. S.</author></authors></contributors><auth-address>Department of Medicine, Mayo Clinic, Rochester, MN.</auth-address><titles><title>Capsule endoscopy device retention and magnetic resonance imaging</title><secondary-title>Proc (Bayl Univ Med Cent)</secondary-title></titles><periodical><full-title>Proc (Bayl Univ Med Cent)</full-title></periodical><pages>270-1</pages><volume>26</volume><number>3</number><dates><year>2013</year><pub-dates><date>Jul</date></pub-dates></dates><isbn>0899-8280 (Print)
0899-8280 (Linking)</isbn><accession-num>23814387</accession-num><urls><related-urls><url>;[100]. In another case, an MRI was performed in a patient with a recurring Crohn’s disease. The MRI revealed a capsule that had been retained for two years due to a stenosis. The capsule was retrieved endoscopically with prior dilatation of the stenosis ADDIN EN.CITE <EndNote><Cite><Author>Zuber-Jerger</Author><Year>2009</Year><RecNum>256</RecNum><DisplayText><style face="superscript">[101]</style></DisplayText><record><rec-number>256</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Zuber-Jerger, I.</author><author>Gelbmann, C. M.</author><author>Endlicher, E.</author><author>Ott, C.</author><author>Obermeier, F.</author></authors></contributors><auth-address>Department of Internal Medicine I, University of Regensburg, Regensburg, Germany. ina.zuber-jerger@klinik.uni-regensburg.de</auth-address><titles><title>Complicated wireless capsule enteroscopy in a patient with Crohn's disease</title><secondary-title>Eur J Gastroenterol Hepatol</secondary-title></titles><periodical><full-title>Eur J Gastroenterol Hepatol</full-title></periodical><pages>952-4</pages><volume>21</volume><number>8</number><keywords><keyword>Adolescent</keyword><keyword>Capsule Endoscopy/ adverse effects</keyword><keyword>Crohn Disease/complications/ diagnosis</keyword><keyword>Foreign Bodies/ complications/therapy</keyword><keyword>Gastrointestinal Hemorrhage/ etiology</keyword><keyword>Humans</keyword><keyword>Ileum</keyword><keyword>Male</keyword><keyword>Recurrence</keyword><keyword>Treatment Outcome</keyword></keywords><dates><year>2009</year><pub-dates><date>Aug</date></pub-dates></dates><isbn>1473-5687 (Electronic)
0954-691X (Linking)</isbn><accession-num>19404201</accession-num><urls></urls></record></Cite></EndNote>[101]. The third case was also a patient with symptoms of recurring Crohn’s disease. An MRI was performed shortly after VCE with the capsule still lying in the colon ADDIN EN.CITE <EndNote><Cite><Author>Berry</Author><Year>2010</Year><RecNum>289</RecNum><DisplayText><style face="superscript">[102]</style></DisplayText><record><rec-number>289</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Berry, P. A.</author><author>Srirajaskanthan, R.</author><author>Anderson, S. H.</author></authors></contributors><auth-address>Department of Gastroenterology, St Thomas' Hospital, London, United Kingdom.</auth-address><titles><title>An urgent call to the magnetic resonance scanner: potential dangers of capsule endoscopy</title><secondary-title>Clin Gastroenterol Hepatol</secondary-title></titles><periodical><full-title>Clin Gastroenterol Hepatol</full-title></periodical><pages>A26</pages><volume>8</volume><number>5</number><keywords><keyword>Adult</keyword><keyword>Capsule Endoscopy</keyword><keyword>Female</keyword><keyword>Foreign Bodies/ diagnosis</keyword><keyword>Humans</keyword><keyword>Magnetic Resonance Imaging</keyword><keyword>Radiography, Abdominal</keyword></keywords><dates><year>2010</year><pub-dates><date>May</date></pub-dates></dates><isbn>1542-7714 (Electronic)
1542-3565 (Linking)</isbn><accession-num>19747984</accession-num><urls></urls></record></Cite></EndNote>[102]. None of the three cases reported adverse events. Due to the interference of the MRI scan, VCE had no diagnostic value. Unpublished personal experience with three other patients incidentally undergoing abdominal MRI with an incorporated VCE confirms these initial reports.Colon capsule endoscopy in patients with contraindication for sodium phosphate The standard colon preparation prior to a colon capsule endoscopy consists of a PEG solution. In addition, sodium phosphate is used as the standard booster solution during the procedure to ensure that the capsule pass through the entire colon within the lifespan of the capsule’s battery. The ESGE guidelines for colon capsule endoscopy recommend the use of sodium phosphate as a booster for all patients with no contraindicationPEVuZE5vdGU+PENpdGU+PEF1dGhvcj5TcGFkYTwvQXV0aG9yPjxZZWFyPjIwMTI8L1llYXI+PFJl
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ADDIN EN.CITE.DATA [104]. Another pilot trial from Japan, where sodium phosphate is contraindicated in hypertensive patients older than 63 years, proposed a diluted Gastrografin solution as an alternative booster based on a capsule excretion rate during recording of 97% (28/29 patients) ADDIN EN.CITE <EndNote><Cite><Author>Togashi</Author><Year>2015</Year><RecNum>240</RecNum><DisplayText><style face="superscript">[105]</style></DisplayText><record><rec-number>240</rec-number><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Togashi, K.</author><author>Fujita, T.</author><author>Utano, K.</author><author>Waga, E.</author><author>Katsuki, S.</author><author>Isohata, N.</author><author>Endo, S.</author><author>Lefor, A. K.</author></authors></contributors><auth-address>Department of Coloproctology, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu-city, Japan.
Department of Gastroenterology, Otaru Ekiseikai General Hospital, Otaru, Japan.
Department of Coloproctology, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu-city, Japan.
Department of Gastroenterology, Otaru Ekiseikai General Hospital, Otaru, Japan.
Department of Gastroenterology, Otaru Ekiseikai General Hospital, Otaru, Japan.
Department of Coloproctology, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu-city, Japan.
Department of Coloproctology, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu-city, Japan.
Department of Surgery, Jichi Medical University, Shimotsuke, Japan.</auth-address><titles><title>Gastrografin as an alternative booster to sodium phosphate in colon capsule endoscopy: safety and efficacy pilot study</title><secondary-title>Endosc Int Open</secondary-title></titles><periodical><full-title>Endosc Int Open</full-title></periodical><pages>E659-61</pages><volume>3</volume><number>6</number><dates><year>2015</year><pub-dates><date>Dec</date></pub-dates></dates><isbn>2364-3722 (Print)
2196-9736 (Linking)</isbn><accession-num>26716132</accession-num><urls></urls></record></Cite></EndNote>[105]. Conclusion Non-invasive VCE is safe, and formal contraindications can be put into perspective when observing some precautions. Based on uneventful clinical application in children, the minimum age has been lowered to 2 years. There is positive in vitro and in vivo evidence that cardiac pacemakers and defibrillators are no contraindication to VCE. Due to missing data, VCE in pregnancy should only be performed in very limited indications in cases where a delay of diagnosis until after delivery may put the mother or the unborn at risk. MRI with retained video capsule should be avoided, although the first reports describe only artifacts prohibiting proper image analysis but no harm to the patient. 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A pilot study evaluating a new low-volume colon cleansing procedure for capsule colonoscopy.?Endoscopy 2012; 44: 482-486 [PMID: 22275051 DOI: 10.1055/s-0031-1291611]105?Togashi K, Fujita T, Utano K, Waga E, Katsuki S, Isohata N, Endo S, Lefor AK. Gastrografin as an alternative booster to sodium phosphate in colon capsule endoscopy: safety and efficacy pilot study.?Endosc Int Open?2015;?3: E659-E661 [PMID: 26716132 DOI: 10.1055/s-0034-1393075]P-Reviewer: Annese V, Figueiredo PN, Kato J, Sauer CGS-Editor: Gong ZM L-Editor: E-Editor:Specialty type: Gastroenterology and hepatologyCountry of origin: GermanyPeer-review report classificationGrade A (Excellent): AGrade B (Very good): B, BGrade C (Good): CGrade D (Fair): 0Grade E (Poor): 0Table 1 Contraindications by manufacturer ProductConditionMedtronicPatency capsuleMedtronicPillCamOlympusEndoCapsuleIntroMedicMirocamCapsovisionCapsoCamJinshan ScienceOMOM capsuleKnown or suspected GI obstruction/obstacles,Fistulae, relevant (small bowel) diverticulosisCCCCRCMotility disorder incl. indigestion or slow gastric emptyingCCCCardiac pacemakers or other implanted electromedical devicesCCCRCSwallowing disorder (dysphagia)CCCCCRCPregnancyRCCCCRCChildren under the age of (years)22 (SB3)18 (Colon, Eso)2Strong electromagnetic fields i.e. MRICCCInability to endure capsule retrieval surgeryCCInability to communicate sufficientlyCConcomitant heart disease or epilepsy (due to electromagnetic radiation)CPillCam Rapid 8 User Manual (DOC-2051-02) ; Olympus EC 10 System User Manual (DE-8602257); IntroMedic Mirocam User Manual v3.9 (MM1100-U-1511); Capsovision CapsoCam SV1 Manual (Doc. No. 1151, Rev. G, ECO 11-0098; OMOM User’s Manual Version 1 (ZSSM-OM00-002). C: Contraindication; GI: gastrointestinal; MRI: Magnetic resonance imaging; RC: relative contraindication. ................
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