Non-small bowel lesion detection at small bowel capsule endoscopy: A comprehensive literature review

Abstract

Small bowel capsule endoscopy is a minimally-invasive endoscopic investigation that is often used in clinical practice to investigate overt or occult gastrointestinal (GI) bleeding among other clinical indications. International guidance recommends small bowel capsule endoscopy as a first-line investigation to detect abnormalities in the small bowel, when gastroscopy and colonoscopy fail to identify a cause of GI bleeding. It can diagnose with accuracy abnormalities in the small bowel. However, there has been increasing evidence indicating that small bowel capsule endoscopy may also detect lesions outside the small intestine that are within the reach of conventional endoscopy and have been probably missed during prior endoscopic investigations. Such lesions vary from vascular deformities to malignancy and their detection often alters patient management, leading to further endoscopic and/or surgical interventions. The current study attempts to review all available studies in the literature and summarise their relevant findings.

Keywords: Obscure gastrointestinal bleeding; Small bowel capsule endoscopy; Non-small bowel lesions; Overt gastrointestinal bleeding; Occult gastrointestinal bleeding; Iron deficiency anaemia

Core tip: Video capsule endoscopy can accurately diagnose small bowel pathology, but often also detects abnormalities in the upper and lower gastrointestinal tract within the reach of conventional endoscopy, that have probably been previously overlooked.