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  • Title: A pilot study of capsule endoscopy after a standard meal for the detection and grading of oesophageal varices in cirrhotic patients.
    Author: Annicchiarico BE, Riccioni ME, Siciliano M, Urgesi R, Spada C, Caracciolo G, Gasbarrini A, Costamagna G.
    Journal: Dig Liver Dis; 2014 Nov; 46(11):997-1000. PubMed ID: 25192604.
    Abstract:
    BACKGROUND: Capsule endoscopy has been proposed as an alternative to fibreoptic endoscopy for oesophageal varices evaluation in cirrhotics. However, it shows only moderate sensitivity compared to fibreoptic endoscopy. AIM: To compare post-meal capsule endoscopy to fibreoptic endoscopy, based on the hypothesis that meal-induced increase of portal pressure can enhance its sensitivity. METHODS: Twenty-five patients were submitted to fibreoptic endoscopy and, after a standard meal, capsule endoscopy. RESULTS: Post-meal capsule endoscopy detected varices in the 18 patients in whom fibreoptic endoscopy detected varices plus 3 more subjects (sensitivity 100%, specificity 70%); large varices in the 4 patients in whom fibreoptic endoscopy graded varices as large, plus 5 more subjects; red markers in the 5 patients in whom fibreoptic endoscopy detected red markers, plus 3 more subjects. High-risk varices were identified in 11 patients by post-meal capsule endoscopy and in 10 by fibreoptic endoscopy (sensitivity 100%, specificity 93.8%). CONCLUSIONS: Post-meal capsule endoscopy identified more varices, large varices and red markers than fibreoptic endoscopy. The two methods detected similar proportions of high-risk varices. These data suggest that a standard meal can enhance the sensitivity of capsule endoscopy in the detection and grading of oesophageal varices in cirrhotics.
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