Endoscopy 2006; 38(4): 385-390
DOI: 10.1055/s-2006-925028
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Video Capsule Endoscopy in Peutz-Jeghers Syndrome: A Blinded Comparison with Barium Follow-Through for Detection of Small-Bowel Polyps

G.  Brown1 [*] , C.  Fraser1 , G.  Schofield1 , S.  Taylor2 , C.  Bartram2 , R.  Phillips3 , B.  Saunders1
  • 1The Wolfson Unit for Endoscopy, St. Mark’s Hospital, Harrow, United Kingdom
  • 2Department of Radiology, St. Mark’s Hospital, Harrow, United Kingdom
  • 3The Polyposis Registry, St. Mark’s Hospital, Harrow, United Kingdom
Further Information

Publication History

Submitted 6 June 2005

Accepted after revision 25 September 2005

Publication Date:
05 May 2006 (online)

Preview

Background and Study Aims: Video capsule endoscopy has shown promise for the surveillance of significant small-bowel polyps in patients with Peutz-Jeghers syndrome. In this study the yield of significant small-bowel polyps by capsule endoscopy was compared to the yield of these polyps by barium follow-through in adults with Peutz-Jeghers syndrome.
Patients and Methods: A total of 19 adults with Peutz-Jeghers syndrome who were undergoing surveillance underwent both capsule endoscopy and barium follow-through examinations, and the number of small-bowel polyps of at least 1 cm in diameter that were detected was recorded for each method. The two methods were assessed in terms of comfort and convenience for the patients and their preferred future surveillance method, using a questionnaire.
Results: Capsule endoscopy detected a median of four significant small-bowel polyps while barium follow-through detected a median of one (P = 0.008). There was a trend towards more participants having at least one significant small-bowel polyp detected by capsule endoscopy than was the case with barium follow-through, though capsule endoscopy seemed to be less reliable for accurate sizing of polyps that were at the limit of clinical significance. Most participants expressed a preference for capsule endoscopy for future surveillance.
Conclusions: Capsule endoscopy should replace barium follow-through for the surveillance of small-bowel polyps in adults with Peutz-Jeghers syndrome, but the findings of this study should be interpreted with caution until a more reliable means of sizing polyps by capsule endoscopy is available.

References

1 * Dr G. Brown is now Associate Specialist in Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia

B. Saunders, M. D.

The Wolfson Unit for Endoscopy · St. Mark’s Hospital

Harrow HA1 3UJ · United Kingdom·

Email: b.saunders@imperial.ac.uk