Video capsule enteroscopy: technical and clinical aspects

PhD ceremony: Ms. J. Westerhof, 13.15 uur, Aula Academiegebouw, Broerstraat 5, Groningen

Dissertation: Video capsule enteroscopy: technical and clinical aspects

Promotor(s): prof. J.H. Kleibeuker

Faculty: Medical Sciences

Until recently, the possibilities to visualize the small bowel with endoscopy were limited. Capsule endoscopy was introduced in 2000. This is a minimally invasive technique that visualizes the entire small bowel. For capsule endoscopy a small capsule is swallowed. It is passively propelled through the intestine by peristalsis; finally the capsule is disposed in the feces. The small bowel capsule generates two images per second. All images are stored on an external data recorder for analysis. Since its introduction, capsule endoscopy has become standard practice in the investigation of suspected small bowel disorders. Indications for capsule endoscopy are obscure gastrointestinal bleeding (after previous normal gastro- and colonoscopy), suspected inflammatory bowel disease and small bowel tumors. Unfortunately, video capsules are unable to take biopsies or perform therapeutic endoscopic interventions, which in contrast are possible with double balloon endoscopy. By alternately inflating and deflating two balloons, stepwise progression of the enteroscope throughout the small bowel is achieved. Given its safety, patient tolerability, and ability to view the entire small bowel, capsule endoscopy can be recommended as the first investigation for suspected small bowel pathology, and, if necessary followed by double balloon enteroscopy.