Page 564 - Clinical Small Animal Internal Medicine

532 Section 6 Gastrointestinal Disease

cuff that surrounds the distal endoscope. These balloons enclosure that is similar in size and shape to a large cap-
VetBooks.ir are sequentially inflated and deflated, and the endoscope sule (Figure 49.20). The capsule is administered to the
patient orally, and after transit through the entire gastro-
advanced, as the small intestinal loops fold up behind the
outer cuff. This technique has been described in a lim-
tal image files. These systems have advantages in avoiding
ited number of canine patients at the time of writing, and intestinal tract is recovered to allow downloading of digi-
has some limitations due to the overall diameter of the the need for anesthesia and postprocedural recovery, and
specific endoscope/cuff combination (13.2 mm) and the arguably allow assessment of the gastrointestinal tract in
increased stiffness and turning radius of the endoscope. a more natural state as the vascular changes induced by
The full exploration of the gastrointestinal tract using patient preparation and anesthesia are avoided.
this endoscope is also a longer procedure than is typical An obvious limitation of the capsule endoscopy sys-
for upper gastrointestinal endoscopy. An advantage of tems is that they are unable to retrieve biopsies, and the
this approach is that biopsy samples can be obtained actual location where a lesion is observed cannot be
from a greater proportion of the gastrointestinal tract, determined with great accuracy as the images are typi-
and discrete lesions within the jejunum may be able to be cally not accessible until after complete transit through
sampled. the gastrointestinal tract. This approach is very useful,
however, for a complete assessment of the gastrointesti-
nal tract for focal lesions, bleeding ulcers, discrete
Capsule Endoscopy
mucosal pathology changes, etc. (Figure 49.21).
Complete assessment of the entire gastrointestinal tract Anatomic landmarks, such as the pylorus, major duode-
of dogs can be obtained in a minimally invasive manner nal flexure, and ileocolic junction, are usually easily
through use of self‐contained capsule endoscopes. These identified, allowing some degree of certainty of the
devices include cameras with 360° field of view, light specific section of the gastrointestinal tract that can be
sources, and digital storage space within a plastic observed.

Further Reading

Evans SE, Bonczynski JJ, Broussard JD, Han E, Baer KE. Larson RN, Ginn JA, Bell CM, Davis MJ, Foy DS. Duodenal
Comparison of endoscopic and full‐thickness biopsy endoscopic findings and histopathologic confirmation of
specimens for diagnosis of inflammatory bowel disease intestinal lymphangiectasia in dogs. J Vet Intern Med
and alimentary tract lymphoma in cats. J Am Vet Med 2012; 26(5): 1087–92.
Assoc 2006; 229(9): 1447–50. Slovak JE, Wang C, Morrison JA, et al. Endoscopic
Goutal‐Landry CM, Mansell J, Ryan KA. Effect of assessment of the duodenum in dogs with
endoscopic forceps on quality of duodenal mucosal inflammatory bowel disease. J Vet Intern Med 2014;
biopsy in healthy dogs. J Vet Intern Med 2013; 27(3): 28(5): 1442–6.
456–61. Slovak JE, Wang C, Sun Y, et al. Development and
Hayes G. Gastrointestinal foreign bodies in dogs and cats: validation of an endoscopic activity score for canine
a retrospective study of 208 cases. J Small Anim Pract inflammatory bowel disease. Vet J 2015; 203(3): 290–5.
2009; 50(11): 576–83. WSAVA International Gastrointestinal Standardization
Jergens AE, Willard MD, Mansell J, et al. Effect of sample Group, Washabau RJ, Day MJ, et al. Endoscopic, biopsy,
quality on the sensitivity of endoscopic biopsy for and histopathologic guidelines for the evaluation of
detecting gastric and duodenal lesions in dogs and cats. gastrointestinal inflammation in companion animals.
J Vet Intern Med 2008; 22(5): 1084–9. J Vet Intern Med 2010; 24(1): 10–26.