Contraindications
Patients With Pacemaker
Cardiac pacemakers are contraindicated with regards to VCE, according to many capsule manufacturers. However, in a study performed in 2004, CE was found to be a safe procedure in five patients with cardiac pacemakers; moreover, the quality of the images was not affected by the pacemakers.[26] Analysis of studies investigating interference between VCE and cardiac devices showed no in vitro and in vivo evidence of interference.[27] Telemetry can interfere with CE video but the CapsoVision capsule stores acquired image data on an internal chip that will be retrieved with the capsule, and by avoiding emission of current or radiofrequency waves, there is no possibility for potential interaction with implanted or external cardiac devices.[27]
High Risk of Intestinal Obstruction
Patients with a history of previous abdominal surgery are not the preferred candidates for VCE because of the risk of the narrowing of the lumen at the site of previous surgery. Additionally, VCE is contraindicated in patients with radiological and clinical evidence of intestinal obstruction.
Difficulty in Swallowing
Patients who experience difficulty in swallowing due to neurological or anatomical reasons may be unable to have VCE, although, sometimes the capsule may be introduced into the stomach via EGD.[28]
Pregnancy
There is little data on VCE in pregnancy. The procedure itself should not pose a risk, except for the low risk of retention.[3] Several studies of VCE have excluded pregnancy because of the possibility of requiring x-ray imaging if the capsule is retained.[29]
Others
There are other contraindications for VCE, such as intestinal pseudo-obstruction, gastroparesis and extensive intestinal diverticulosis, and VCE is also believed not to be suitable for young children. However, further studies and research are necessary to confirm these contraindications.
Expert Rev Gastroenterol Hepatol. 2013;7(4):323-329. © 2013 Expert Reviews Ltd.
