Capsule endoscopy features of human immunodeficiency virus and geographical diseases.

Abstract

In the 1860s a golden spike was driven near Ogden, Utah, marking the completion of the American transcontinental railroad bridging East and West Coasts. This seminal event in American history opened up a new era of exploration and discovery, leading to a whole new appreciation of the continent. Capsule enteroscopy has now effectively bridged the void in the gastrointestinal (GI) tract between the maximum depth of insertion of the push enteroscope and the proximal advancement of the colonoscope. Just as multiple new disease entities and new manifestations of established ones were made at the time of the wide spread availability of endoscopy, so too newer diseases and newer manifestations of well-described diseases are now possible with the advent of capsule enteroscopy. Small bowel manifestations of classical diseases were largely described based on information gained at surgery, autopsy, or contrast radiography. Because so few patients with small bowel diseases are definitely visualized, one’s understanding of these diseases is based on the most glaring complications of far-advanced disease. Capsule enteroscopy enables us to visualize and describe earlier and atypical manifestations of these diseases (Figs. 1–7). HIV and AIDS is clearly a global problem infecting probably 100 million individuals around the globe. Even the recently described GI manifestations of AIDS needs to be extended and amplified now in the era of capsule enteroscopy. In addition to the enteric manifestations of HIV disease, now readily available for observational diagnosis by capsule endoscopy, certain diseases unique to particular regions of the globe are being discovered by capsule enteroscopy (see