Enteroscopy in diagnosis and treatment of small bowel bleeding: A Delphi expert consensus.

Background: Enteroscopy plays an important role in the management of small bowel bleeding. However, current guidelines are not specifically designed for small bowel bleeding and recommendations from different international societies do not always align. Consequently, there is heterogeneity in the definitions of clinical entities, clinical practice policies, and adherence to guidelines among clinicians.

Quality performance measures for small capsule endoscopy: Are the ESGE quality standards met?

 The European Society of Gastrointestinal Endoscopy (ESGE) recently issued a quality performance measures document for small bowel capsule endoscopy (SBCE). The aim of this nationwide survey was to explore SBCE practice with ESGE quality measures as a benchmark.  A dedicated per-center semi-quantitative questionnaire based on ESGE performance measures for SBCE was created by a group of SBCE experts.

Small-Bowel Capsule Endoscopy in Clinical Practice: Has Anything Changed Over 13 Years?

Background: In Lombardia, one of the 20 Italian administrative Regions, small-bowel capsule endoscopy (SBCE) was introduced in 2001. In January 2011, the Regional Health Authorities established a reimbursement for outpatient SBCE.

Aim: To prospectively record data on SBCE between 2011-2013 and compare them to similar data retrospectively collected from the same geographical area (covering the period 2001-2008) and published in 2008.

Implications of small-bowel transit time in the detection rate of capsule endoscopy: A multivariable multicenter study of patients with obscure gastrointestinal bleeding.

Aim: To define the role of small-bowel transit time in the detection rate of significant small-bowel lesions.

Methods: Small-bowel capsule endoscopy records, prospectively collected from 30 participating centers in the Lombardy Registry from October 2011 to December 2013, were included in the study if the clinical indication was obscure gastrointestinal bleeding and the capsule reached the cecum. Based on capsule findings, we created two groups: P2 (significant findings) and P0-1 (normal/negligible findings).

First report of splenic rupture following deep enteroscopy.

Splenic rupture is a rare complication of diagnostic and therapeutic gastrointestinal endoscopy procedures. Herein, we report for the first time a case of splenic rupture following therapeutic retrograde double-balloon enteroscopy, which occurred in an 85-year-old man who was treated for recurrent mid-intestinal bleeding that resulted from ileal angioectasia. This patient promptly underwent an operation and eventually recovered.

Can we improve the detection rate and interobserver agreement in capsule endoscopy?

Background: Data about strategies for improving the diagnostic ability of capsule endoscopy readers are lacking.

Aim: (1) To evaluate the detection rate and the interobserver agreement among readers with different experience; (2) to verify the impact of a specific training (hands-on training plus expert tutorial) on these parameters.

Methods: 17 readers reviewed 12 videos twice; between the two readings they underwent the training.

[Capsule endoscopy in Crohn's disease].

Capsule endoscopy appropriateness in Crohn's disease.The incidence of Crohn's disease is steadily growing in western countries and the diagnosis is still delayed from symptoms onset by several years. Up to one third of patients have exclusive disease location in the small bowel, the tract less accessible to conventional diagnostic visualization.