Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jan 7, 2010; 16(1): 63-68
Published online Jan 7, 2010. doi: 10.3748/wjg.v16.i1.63
Z-line examination by the PillCam™ SB: Prospective comparison of three ingestion protocols
Ignacio Fernandez-Urien, Erika Borobio, Inmaculada Elizalde, Rebeca Irisarri, Juan Jose Vila, Jesus Maria Urman, Javier Jimenez
Ignacio Fernandez-Urien, Erika Borobio, Inmaculada Elizalde, Rebeca Irisarri, Juan Jose Vila, Jesus Maria Urman, Javier Jimenez, Department of Gastroenterology, Hospital of Navarra, Irunlarrea 3, 31080 Pamplona, Spain
Author contributions: Fernandez-Urien I designed the study, wrote the paper and reviewed capsule videos; Borobio E and Elizalde I reviewed capsule videos; Irisarri R and Urman JM collected the data; Vila JJ performed the statistical analysis; Jimenez J reviewed and corrected the paper.
Correspondence to: Ignacio Fernandez-Urien, MD, Department of Gastroenterology, Hospital of Navarra, Irunlarrea 3, 31080 Pamplona, Spain. ifurien@yahoo.es
Telephone: +34-948-647612350 Fax: +34-948-848422303
Received: July 14, 2009
Revised: September 7, 2009
Accepted: September 14, 2009
Published online: January 7, 2010
Abstract

AIM: To evaluate the Z-line visualization by the PillCam™ SB2 using three different ingestion protocols.

METHODS: Ninety consecutive patients undergoing small bowel capsule endoscopy (SBCE) between January and May 2008 were included in the study. They swallowed the capsule in the standing (Group A = 30), supine (Group B = 30) and right supine positions (Group C = 30). Baseline patient characteristics, difficulties in capsule ingestion, esophageal transit times (ETT) and Z-line visualization were noted.

RESULTS: No significant differences were found between the groups with regard to baseline patient characteristics, ingestion difficulties and complete SB examinations (P > 0.05). At least 1 frame of the Z-line was detected in 15.8%, 46.7% and 90% of patients in groups A, B and C, respectively (P < 0.001). The average number of Z-line images was 0.21 ± 0.53, 3.23 ± 6.59 and 5.53 ± 7.55 and the mean % of the Z-line detected was 71.3, 25.1 and 8.3, in groups A, B and C, respectively (both P < 0.001). ETT times were longer in the supine group followed by the right supine and the standing groups (median of 237 s vs 64 s and 39 s, respectively; P < 0.001).

CONCLUSION: Z-line visualization in patients undergoing SBCE can be accurately achieved in most cases when the capsule is swallowed in the right supine position.

Keywords: Barrett; Capsule endoscopy; Esophagus; Gastroesophageal reflux disease; Ingestion; Varices; Z-line