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Capsule Endoscopy: Clinical Case Vignettes

Capsule Endoscopy: Clinical Case Vignettes . David J. Hass, MD Assistant Clinical Professor of Medicine Yale University School of Medicine Gastroenterology Center of Connecticut, P.C. Case. 30 year-old male Recurrent abdominal pain and loose stools WBC 12. Hct 31. CRP 14.

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Capsule Endoscopy: Clinical Case Vignettes

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  1. Capsule Endoscopy:Clinical Case Vignettes David J. Hass, MD Assistant Clinical Professor of Medicine Yale University School of Medicine Gastroenterology Center of Connecticut, P.C.

  2. Case • 30 year-old male • Recurrent abdominal pain and loose stools • WBC 12. Hct 31. CRP 14. • Stool studies negative

  3. Case • Appears well, but fatigued. • Lungs clear to auscultation, normal cardiac exam • Hyperactive bowel sounds, right lower quadrant tenderness and minimal guarding • Exam otherwise unremarkable

  4. Case • CT scan revealing for thickened proximal ileal loop • Colonoscopy negative with deep ileal intubation • Small bowel series negative

  5. Case • Capsule endoscopy performed….

  6. Case • Capsule endoscopy revealed: • Apthous ulcerations • Congested mucosa • Hemorrhagic mucosa • Findings consistent with small bowel Crohn’s Disease

  7. Case • Patient initiated on budesonide 9 mg daily • Considerable improvement with complete resolution of abdominal pain. • CBC normalized

  8. Case • Capsule endoscopy is superior to conventional techniques for early detection of Crohn’s disease. • By early detection of small bowel lesions, CE can lead to earlier diagnosis and treatment, resulting in improved quality of life.

  9. References • Gastrointestinal Endoscopy 2006;63(4):539-545. • Triester et al. Am J Gastroenterol 2006;101:954-964. • Faigel, DO and Cave, DR. Capsule Endoscopy.2008 Elsevier Inc:91-104.

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