Clinical relevance of patency capsule combined with abdominal ultrasonography to detect small bowel strictures

BACKGROUNDPillCam patency capsule (PC) is a novel and radiofrequency identification tag-free device that remains intact in the gastrointestinal tract for 30–33 h after ingestion and then disintegrates. The aim of this study was to determine the clinical relevance of PC combined with abdominal ultrasonography as a reliable indicator of functional patency. PATIENTS AND METHODSThe study was prospective and PillCam PC was administered to consecutive patients with known or suspected small bowel strictures. PC was verified if it was excreted intact in 33 h after administration. Following excretion failure and radiograph detection in the pelvic cavity, ultrasonography was used to detect the PC in relation to the stricture. RESULTSThe participants were 52 patients with known or suspected small bowel strictures (58% women, mean age 51 years, including 32 with or suspected Crohn’s disease). Twenty-two patients (42.3%) retrieved PC in the stool within 33 h after ingestion. Radiograph identified the four PCs in the colon and eight were not observed. Ultrasonography precisely judged all 17 PCs retained including six PCs at the proximal side of small bowel stricture in the patients considered ineligible for capsule endoscopy (CE). In all eligible patients, CE passed through the small intestine without incident. CONCLUSIONPillCam PC combined with ultrasonography before CE appears to be a reliable indicator of functional patency to predict and minimize the risk of impaction in suspected or even known cases with small bowel stricture.