Video capsule endoscopy (VCE) is a powerful diagnostic tool that has proven especially useful in imaging the small intestine. VCE technology offers greater magnification than traditional endoscopy while also providing excellent resolution. It is a clinically useful tool for detecting occult bleeding and superficial lesions that are not radiographically observed; it may also provide functional information as the capsule moves passively through the small intestine. The development of endoscopy enabled direct visualization of the esophagus, stomach, proximal small bowel, and colon. However, even with these technological advances, certain limitations remained in the noninvasive diagnosis of gastrointestinal (GI) tract pathology. Much of the small bowel is not accessible with traditional endoscopy or even push endoscopy (which allows imaging up to 80-120 cm beyond the ligament of Treitz) but can be visualized with the capsule endoscope (see the image below). Capsule endoscopy is superior to radiographic techniques in the detection of mucosal disease and angiodysplasia. Investigators have capitalized on the advantages of this approach, revealing an expanding list of clinical indications. VCE has primarily been used as a diagnostic tool for detecting obscure GI bleeding, but it has also aided in the diagnosis of inflammatory bowel disease (IBD) and celiac disease and helped in the detection of small bowel neoplasia. Obscure gastrointestinal bleeding. GI bleeding is obscure when it continues or recurs after upper and lower endoscopic examinations have found no source. Most obscure GI bleeding is due to lesions in the small intestine, a region that has traditionally been difficult to image adequately. Before VCE, the standard procedure comprised a combination of diagnostic methods, including upper endoscopy, colonoscopy, and push enteroscopy, as well as enteroclysis, nuclear bleeding scans, angiography, and small-bowel follow-through studies. emedicine.medscape/article/197525-overview#aw2aab6b3
Posted on: Thu, 18 Dec 2014 08:55:55 +0000
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