Telescopes for Inner Space: Fiber Optics and Endoscopes
Suzanne Amador Kane, Boris A. Gelman in Introduction to Physics in Modern Medicine, 2020
An alternative to using endoscopes for imaging parts of the gastrointestinal tract is video capsule endoscopy employing a self-contained “camera pill” (Figure 2.19). Just as it sounds, this device is a tiny self-contained camera, light source, and video transmitter all in one compact, roughly 1-cm-long package. Patients swallow the camera pill in a doctor's office, then go about their daily activities while it makes its way through the digestive tract, moving by the natural method of peristalsis and taking a series of images two times a second as it goes. The patient wears about the waist a data recorder that receives and records transmitted images from the camera pill for later analysis. Video capsule endoscopy is useful for imaging parts of the digestive tract, such as the deeper reaches of the small intestine, difficult to access using endoscopes, and has FDA approval for such examinations in the US. Despite its small size, the resolution of the camera pill is 0.1 mm, only somewhat coarser than regular endoscopy. Some drawbacks relative to colonoscopy or endoscopy of the upper gastrointestinal tract include the lack of ability to select the orientation of images, the inability to sample tissues for biopsy, and clinical approval only for small intestine imaging thus far. The next generation of active capsule endoscopy is slated to address some of these problems with devices that can propel and steer themselves.
Bowel disorders
Henry J. Woodford in Essential Geriatrics, 2022
Initial investigations should include blood tests (e.g. FBC, urea and electrolytes, liver function tests, vitamin B12, folate, calcium, ferritin, erythrocyte sedimentation rate, C reactive protein and TSH). When an infectious source is likely, a stool sample can be tested. Faecal calprotectin is a marker of inflammation in the bowel wall, which can be used to help differentiate between IBS and inflammatory bowel disease in younger people. It is less useful in older people. In younger people, a negative faecal haemoglobin tests test makes colorectal cancer less likely and colonoscopy might be avoided. It is unlikely to alter management in older people with a change in bowel habits. Colonoscopy is usually recommended for chronic diarrhoea and will detect an abnormality in 15–20% of cases. In people with moderate to severe frailty, flexible sigmoidoscopy or CT virtual colonoscopy are less invasive alternatives, but will they affect management? CT and MR enterography or capsule endoscopy are sometimes used to image the small bowel.
Tropical Colorectal Surgery
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Currently, for intra-abdominal and extraintestinal TB, contrast enhanced computerised tomography of the abdomen with multiplanar imaging and 3-D reconstruction is the imaging modality of choice.8 It is helpful in the delineation of mucosal pathology, stricture and fistula. Upper and lower intestinal endoscopy and enteroscopy will provide a comprehensive view of the entire intestinal tract and allows for biopsy of tissue. Capsule endoscopy is an alternative to enteroscopy, but biopsy of tissue is not possible, only images. Before capsule endoscopy is undertaken, it is essential to exclude intestinal stricture by prior water-soluble contrast study or MRI enteroclysis, lest the capsule becomes impacted at the site of luminal narrowing.
Faecal calprotectin detects subclinical bowel inflammation and may predict treatment response in spondyloarthritis
Published in Scandinavian Journal of Rheumatology, 2018
RD Østgård, BW Deleuran, MY Dam, IT Hansen, AG Jurik, H Glerup
The endoscopic procedures followed standard procedures at Silkeborg Regional Hospital, Silkeborg, Denmark. In brief, the patient followed a low-fibre or clear-liquid-only diet for capsule endoscopy. For colonic examination, an additional laxative preparation was given. For capsule endoscopy, the patient swallowed a pill camera (PillCamSB2; Given Technologies, Yoqneam, Israel), which transmitted pictures to a receiver carried around the waist. Pictures were transmitted to a computer. The film was examined and scored according to the Lewis protocol by an experienced endoscopist (HG). The Lewis score is a scoring system for detecting inflammatory changes in the small bowel (23). The colonoscopy was performed in a same-day surgery setting. The patient was sedated according to the standard protocol with midazolam and fentanyl. During the colonoscopy, biopsies were taken systematically from all parts of the colon and terminal ileum (21 biopsies) following the usual guidelines.
Addressing priority challenges in the detection and assessment of colorectal polyps from capsule endoscopy and colonoscopy in colorectal cancer screening using machine learning
Published in Acta Oncologica, 2019
Victoria Blanes-Vidal, Gunnar Baatrup, Esmaeil S. Nadimi
A fully paired back to back study was carried out from spring 2015 to spring 2016, including 255 participants that were positive in the FIT from the national screening program in Denmark. First, the participants had a CCE investigation by a second-generation capsule endoscopy system (PillCam COLON 2). Polyps size, morphology and location were estimated from CCE recorded videos using the standard tool in the RAPID™ Software (Medtronic, Minneapolis, MN, USA). The day after CCE investigation, the endoscopists carried out an OC using a standardized colonoscope (Olympus) and estimated the in vivo polyp size, morphology and location. Only endoscopists with >2500 previous OC´s performed the OC’s. The endoscopist did not routinely use size-measurement tools. After polyp removal and formalin fixation, the postfixation size was measured by a pathologist. Observers were blinded for the results of the other assessments. In case polyps were seen in CCE but not in OC, the patient was offered a second OC with polypectomy. The polyps detected in the second OC were not used for CCE-OC polyp matching and comparison, but only to investigate the existence of false negatives in the first colonoscopy and ensure best possible treatment of the patient. The study was approved by the Local Ethics Committee (S20140141) and registered at clinicaltrials.gov (NCT02303756). At least 113 polyps need to be included in this observational study according to the sample size calculation based on the Pearson coefficient with a Type I error of 0.05, a Type II error of 0.1 (power 90%) and an expected correlation coefficient of 0.3.
Advances in tests for colorectal cancer screening and diagnosis
Published in Expert Review of Molecular Diagnostics, 2022
Sarah Cheuk Hei Chan, Jessie Qiaoyi Liang
Colon capsule endoscopy (CCE) is an imaging modality where the patient swallows a pill-sized video camera that passes through the entire gastrointestinal tract. Images from the camera are transmitted to a data recorder and downloaded using a software for doctors to view. Up to the time of writing, two generations of colon capsules have been released into the market [133]. Studies have shown that CCE can be an accurate noninvasive method for CRC screening. The sensitivity of the second-generation colon capsule in detecting polyps >6 mm ranges from 79% to 86%, while the specificity ranges from 88.1% to 97%. For polyps >10 mm, the sensitivity is between 80% and 88%, while the specificity is between 95.3% and 99% [134–136]. CCE is a safe method and does not require sedation. In addition, patients can continue to perform most daily activities whilst undergoing colonic evaluation, which may be appealing to those who would otherwise not consider colonoscopic screening [136].
Related Knowledge Centers
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