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. 2007 Oct;3(10):777-85.

Capsule endoscopy in the evaluation of obscure gastrointestinal bleeding: a comprehensive review

Feng Li  1 , Jonathan A Leighton, Virender K Sharma
Affiliations

Capsule endoscopy in the evaluation of obscure gastrointestinal bleeding: a comprehensive review

Feng Li et al. Gastroenterol Hepatol (N Y). 2007 Oct.

Abstract

Historically, the evaluation of patients with obscure gastrointestinal bleeding (OGIB) has been often suboptimal, due to the limited ability to adequately image the small bowel. However, over the past several years, significant improvements have been made in small-bowel imaging techniques, both endoscopically and radiologically. Since the introduction of capsule endoscopy (CE) in particular, the diagnostic and therapeutic approaches to OGIB have improved significantly. Capsule-based technology has enabled a more rapid and accurate diagnosis of many small-bowel disorders. Capsule endoscopy is safe and well tolerated. Many prospective comparative studies have shown that the diagnostic yield of CE is superior compared to other endoscopic and radiologic modalities. Numerous other studies have also shown that CE leads to a significant change in management and improved outcomes.

Keywords: Capsule endoscopy; enteroscopy; obscure bleeding; small-bowel radiology.

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Figures

Figure 1
Figure 1
Small-bowel capsule endoscope (PillCam, Given Imaging).
Figure 2
Figure 2
Capsule endoscopy recording devices and computer workstation.
Figure 3
Figure 3
Capsule endoscope reading software interface.
Figure 4
Figure 4
Angioectasia of small bowel seen on capsule endoscopy in a patient with obscure gastrointestinal bleeding.
Figure 5
Figure 5
Nonsteroidal anti-inflammatory drug–induced enteropathy, with ulcerated diaphragm-like stricture seen on capsule endoscopy in a patient with obscure gastrointestinal bleeding.
Figure 6
Figure 6
Crohn's disease of the small bowel, with ulceration and stenosis of the lumen seen on capsule endoscopy in a patient with obscure gastrointestinal bleeding.
Figure 7
Figure 7
Forest plot showing clinically significant findings on capsule endoscopy (CE) compared with push enteroscopy (PE) in patients with obscure gastrointestinal bleeding (A). Forest plot showing clinically significant findings on capsule endoscopy (CE) compared with small-bowel barium radiography (SBR) in patients with obscure gastrointestinal bleeding (B). Data adapted from Triester et al. IY

incremental yield

CI

confidence interval.

Figure 8
Figure 8
Capsule delivery system for endoscopic delivery of capsule into the small intestine in patients with swallowing difficulty, gastroparesis, or gastric outlet obstruction (AdvanCE, US Endoscopy).
Figure 9
Figure 9
Self-dissolvable patency capsule for the diagnosis of significant small-bowel stricture prior to capsule endoscopy.
Figure 10
Figure 10
Algorithm for the Agile patency capsule for the diagnosis of significant small-bowel stricture prior to capsule endoscopy.
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References

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