Video Capsule Endoscopy and Deep Enteroscopy

Abstract

Until 2001, the nonsurgical evaluation of the small intestine was largely limited to the use of radiologic imaging (e.g., small bowel follow-through or enteroclysis). With the now widespread availability of video capsule endoscopy and deep enteroscopy since 2001, we are now able to visualize the length and most of the mucosa of the small intestine and manage small bowel lesions that were previously inaccessible except by surgical intervention. This review serves as an overview for these two procedures, detailing the indications and contraindications, proper timing of the procedure, technical aspects of the devices themselves, possible complications, and outcomes. Figures show endoscopic images that demonstrate multiple angioectasias, bleeding during capsule endoscopy, active Crohn disease of the small bowel, severe mucosal scalloping, small bowel carcinoid tumor, small bowel polyp associated with Peutz-Jeghers syndrome, and nonsteroidal antiinflammatory drug enteropathy; serial x-rays of a patient with a patency capsule retained inside the small intestine; a computer image showing the distribution of small bowel tumors; and a pie chart displaying the breakdown of the distribution of benign and malignant tumors that can be found in the small intestine. Videos show multiple angioectasias, bleeding during capsule endoscopy, active Crohn disease of the small bowel, small bowel carcinoid tumor, and small bowel polyp associated with Peutz-Jeghers syndrome. This review contains 10 highly rendered figures, 5 videos, and 50 references.