ASGE Masterclass: Capsule Quest – Journey Through the Future of GI Diagnostics (On-demand) | March 2025-Trouble in Paradise - Navigating Limitations and Complications

Pdf Summary

The document is a master class presentation by Dr. Roopa Vemulapalli on the complexities of capsule endoscopy, focusing on its limitations and potential complications. No financial conflicts of interest are disclosed. Several capsule endoscopy products are compared, highlighting their specifications such as camera count, field of view, battery life, and special features like AI assistance and magnetic control.<br /><br />Key learning objectives include identifying pitfalls and managing complications associated with capsule endoscopy. Limitations like incomplete examinations and poor diagnostic yield are explored, alongside factors causing prolonged gastric transit time and low diagnostic efficiencies, such as patient selection and quality of bowel preparation. Notable strategies include using capsules with longer battery lives, employing real-time viewing and AI-assisted navigation to improve completion rates, and utilizing prokinetics selectively.<br /><br />The document addresses interpretation challenges due to reading time and reader fatigue, suggesting that automated software may reduce reading time but have limitations. It stresses the significance of reader competency, suggesting structured training programs. Mimickers, overdiagnosis, and conditions like capsule retention and interference with cardiac devices are also discussed.<br /><br />Complications such as perforation, capsule aspiration, and retention are scrutinized, including prevention and management strategies like patient screening, using patency capsules, and employing device-assisted enteroscopy for retrievals or interventions. Additionally, the importance of reducing missed lesions through controlled viewing speeds and accurate interpretation is emphasized.<br /><br />A summary of strategies to mitigate these issues includes proper patient selection, informed consent, using imaging techniques to assess retention risks, conducting timely procedures post-bleeding, applying real-time viewing in select cases, and ensuring competency in procedure execution and interpretation. These strategies aim to enhance diagnostic yield and minimize risks associated with capsule endoscopy.

Asset Caption

Learning Objectives:
1. Identify potential pitfalls and how to steer clear of them.
2. Learn proactive strategies to manage and prevent complications

Keywords

capsule endoscopy

complications

limitations

AI assistance

diagnostic yield

patient selection

reader competency

capsule retention

prokinetics

device-assisted enteroscopy