Atlas of video capsule endoscopy

Wireless capsule endoscopy represents a revolutionary advance in noninvasive imaging of the digestive tract, particularly the small bowel. Well over 300,000 examinations have been performed in a relatively short time, testifying to the enormous unmet need to conquer the last bastion in digestive endoscopy. Capsule technology was developed to assist in the evaluation of diseases of the entire digestive tract, from the esophagus to the colon, but especially of the small bowel where it facilitates discovery of d- eases that are often not detectable with other modalities. Potential clinical indications and applications are constantly expanding. Currently, evaluation of obscure gastrointestinal bleeding is the foremost important indication for capsule endoscopy, occasionally followed by push enteroscopy or double-balloon endoscopy. The mean diagnostic value of capsule endoscopy for finding the cause of obscure bleeding is approximately 60%. The clinical utility of capsule endoscopy in the diagnosis of Crohn’s disease continues to evolve. Capsule endoscopy appears particularly useful in patients, including children, who have symptoms and signs suggestive of Crohn’s disease, when conventional diagnostic modalities remain negative. Other novel indications abound such as villous atrophy in celiac disease, lymphangiectasia, nodular lymphoid hyperplasia, drug-induced mucosal injury, radiation damage etc. Before introduction of the capsule, it was not r eadily possible to establish the extent of small bowel involvement in celiac disease. The strength of the capsule seems to lie in its ideal ability to diagnose, monitor, and assess complications in the latter disease.