Gastrointestinal semptomlara göre kapsül endoskopinin açıklayıcı gücü ve önemi

Yıl 2018, Cilt: 26 Sayı: 1, 17 - 26, 26.04.2018

Süleyman Orman , Orhan Sami Gültekin

https://doi.org/10.17940/endoskopi.410494

Öz

Giriş ve Amaç: Kapsül endoskopi sebebi bulunamayan gastrointestinal semptomları araştırmada sıklıkla kullanılan bir tanı yöntemidir. Amacımız gastrointestinal semptomlara göre kapsül endoskopinin açıklayıcı gücü ve önemini saptamaktır. Gereç ve Yöntem: Kapsül endoskopi yapılan 95 hasta retrospektif olarak değerlendirildi. Hastaların demografik verileri, şikayetleri, kapsül endoskopik verileri, gastroskopi ve kolonoskopi sonuçları değerlendirildi. Bulgular: Hastaların %38,9’u (n=37) kadın; %61,1’i (n=58) erkek idi. İşlemler sırasında toplam 141 lezyon saptandı. Olguların yaş ortalaması 56,98±18,95 (14-92) idi. Gizli gastrointestinal sistem kanaması ile başvuran hastalarda 44 lezyon saptanmış olup bunların %61,4’ü jejunumda idi. Açık gastrointestinal sistem kanaması ile başvuran hastalarda 56 lezyon saptanmış olup bunların %42,9’u jejunumda idi. İshal ile başvuran hastalarda 16 lezyon saptanmış olup bunların %50’si ileumda yer almaktaydı. Karın ağrısı ile başvuran hastalarda 25 lezyon saptanmış olup bunların %56’sı ileumda görülmekte idi. Açık ve gizli gastrointestinal sistem kanaması şikayetleri bulunan hastalarda en sık saptanan lezyon türü ve yeri jejunal angiodisplaziler olup sırasıyla 21/37 ve 20/32 olarak saptandı. İshal ve karın ağrısı şikayetleri bulunan hastalarda en sık saptanan lezyon türü ve yeri ileal Crohn hastalığı olup sırasıyla 4/5 ve 3/4 olarak saptandı. Semptom sayısına göre hastalardeğerlendirildiğinde hastaların %41.1’inde (n=39) yalnızca tek semptom olduğu gözlendi. Semptomlar tek tek ele alındığında hastaların en sık anemi (49/170) ile başvurduğu gözlenmiştir. Anemi ile başvuran hastaların %79,6’sında herhangi bir lezyon saptanmıştır. Ancak herhangi bir lezyon saptananların %97,4’ünün patolojiyi açıklayıcı lezyon olduğu gözlenmiştir. Sonuç: Kapsül endoskopi uygun endikasyonla kullanıldığında gastrointestinal semptomların nedenini saptamada oldukça etkin bir tanı yöntemidir.

Anahtar Kelimeler

Kapsül endoskopi, gastroskopi, kolonoskopi

Explanatory power and importance of capsule endoscopy according to gastrointestinal symptoms

Öz

Background and Aims: Capsule endoscopy is a commonly used diagnostic method for investigating gastrointestinal complaints that are not detected by endoscopy. Our aim is to determine the explanatory power and importance of capsule endoscopy according to the type of gastrointestinal symptoms. Materials and Methods: A total of 95 patients who underwent capsule endoscopy were retrospectively evaluated. Demographic data, complaints, capsule endoscopic data, gastroscopy, and colonoscopy results were evaluated. Results: Of the total patients, 38.9% (n= 37) were female and 61.1% (n= 58) were male. A total of 141 lesions were detected during the procedures. The mean age of the cases was 56.98±18.95 (range: 14-92). Forty-four lesions were detected in patients with obscure gastrointestinal bleeding, of which 61.4% were found in the jejunum. In the patients with overt gastrointestinal bleeding, 56 lesions were found, of which 42.9% were in the jejunum. Sixteen lesions were found in patients with diarrhea, and 50% of them were in the ileum. Twenty-five lesions were found in patients with abdominal pain, and 56% of them were in the ileum. Jejunal angiodysplasia was the most common lesion type and location in patients with overt and occult gastrointestinal bleeding complaints, 21/37 and 20/32, respectively. Patients with diarrhea and abdominal pain had the most common type and location of ileal Crohn’s disease, 4/5 and 3/4, respectively. According to the number of symptoms, 41.1% (n= 39) of patients had only one symptom upon evaluation. Examination of individual symptoms revealed that patients were most frequently referred with anemia (49/170). In all, 79.6% of patients with anemiahad lesions; however, 97.4% of these lesions were elucidatory. Conclusion: Capsule endoscopy is a very effective diagnostic method when it is used with appropriate indications to determine the origin of gastrointestinal symptoms.

Anahtar Kelimeler

Capsule endoscopy, gastroscopy, colonoscopy

Kaynakça

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