wirelesscapendocrohndisease培训教程文件.pptVIP

Wireless Capsule Endoscopy In Crohn’s Disease Eric Goldberg, M.D. Director of VA GI Endoscopy Assistant Professor of Medicine University of Maryland Medical Center November 19th, 2005 Capsule Endoscopy for IBD SS is a 40 year old male with a past medical history of ulcerative colitis s/p total proctocolectomy with ileostomy for dysplasia. Post operative course complicated by an SBO requiring small bowel resection. SS did well for 11 years following his colectomy but then developed bright red blood in his ileostomy bag and abdominal pain. Ileoscopy: Normal EGD: Normal SBFT: Normal Small Bowel Follow Through Evaluation of the Small Intestine Push Enteroscopy 2.5meter long push enteroscopy Sonde and rope-way enteroscopy CT Enterography Small Bowel MRI’s Intra-operative enteroscopy Double Balloon Enteroscopy The Capsule Diameter 11mm: Length 26mm Optical dome: Intestinal illumination by white light emitting diodes (LED’s) Lens Complementary metal-oxide silicone imager (color camera chip) Transmitter Two batteries (silver oxide) Features of the Capsule Capsule takes two images per second On average, 50,000 images are obtained during an 8 hour exam Magnification: 8x Capsule coating: non-adherant Disposable “Physiologic Endoscopy” Bowel is visualized in its normal state No “scope trauma” Air insufflation not a factor Exam can be performed on anticoagulation Performance Overnight 12 hour fast Sensors placed on patient Patient wears a belt that contains a battery pack and data recorder. Patient ingests capsule around 8am Patient may have clears two hours after ingestion Patient may have a light lunch 4 hours after ingestion Avoid other patients who ingested a capsule. Patient returns 7-8 hours later Indications Obscure gastrointestinal bleeding Evaluation of extent of small intestinal disorders such as Crohn’s disease or Celiac sprue Abnormal small intestinal imaging Suspected malabsorption Surveillance of polyposis syndromes involving small intestine Complica