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Review
. 2007 Dec 14;13(46):6140-9.
doi: 10.3748/wjg.v13.i46.6140.

Small bowel capsule endoscopy in 2007: indications, risks and limitations

Emanuele Rondonotti  1 , Federica Villa, Chris J J Mulder, Maarten A J M Jacobs, Roberto de Franchis
Affiliations
Review

Small bowel capsule endoscopy in 2007: indications, risks and limitations

Emanuele Rondonotti et al. World J Gastroenterol. .

Abstract

Capsule endoscopy has revoluzionized the study of the small bowel by providing a reliable method to evaluate, endoscopically, the entire small bowel. In the last six years several papers have been published exploring the possible role of this examination in different clinical conditions. At the present time capsule endoscopy is generally recommended as a third examination, after negative bidirectional endoscopy, in patients with obscure gastrointestinal bleeding. A growing body of evidence suggests also an important role for this examination in other clinical conditions such as Crohn's disease, celiac disease, small bowel polyposis syndromes or small bowel tumors. The main complication of this examination is the retention of the device at the site of a previously unknown small bowel stricture. However there are also some other open issues mainly due to technical limitations of this tool (which is not driven from remote control, is unable to take biopsies, to insufflate air, to suck fluids or debris and sometimes to correctly size and locate lesions). The recently developed double balloon enteroscope, owing to its capability to explore a large part of the small bowel and to take targeted biopsies, although being invasive and time consuming, can overcome some limitations of capsule endoscopy. At the present time, in the majority of clinical conditions (i.e. obscure GI bleeding), the winning strategy seems to be to couple these two techniques to explore the small bowel in a painless, safe and complete way (with capsule endoscopy) and to define and treat the lesions identified (with double balloon enteroscopy).

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Figures

Figure 1
Figure 1
Normal small bowel.
Figure 2
Figure 2
Published papers about capsule endoscopy between 2001 and 2007 (search engine: www.pubmed.org, key words: Capsule endoscopy OR capsule enteroscopy). 1Estimated number of published articles in 2007 based on the number of papers published in the first seven months of the year.
Figure 3
Figure 3
Artero-Venous Malformation (AVM) of the distal duodenum in a patient undergoing capsule endoscopy for obscure GI bleeding.
Figure 4
Figure 4
Jejunal ulcers in a patient with Crohn’s disease.
See this image and copyright information in PMC

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