The usefulness of video capsule endoscopy for small bowel diseases

Until recently, the diagnosis of small bowel disease by the endoscopic procedure was difficult due to the organ characteristics. Video capsule endoscopy (VCE), which enables the whole small bowel observation safely and noninvasively, was introduced in 2000 and these problems are now being resolved. The best adaptation of VCE is the diagnosis of obscure gastrointestinal bleeding (OGIB) and its diagnostic value is superior to other imagings. For OGIB, the algorithm of the diagnosis has been established. In addition, it is useful for the inspection of small bowel tumor, and the diagnostic rate was 84.1% in our study. But VCE sometimes misses small bowel tumors, and we should recognize that. Besides, the quantitative diagnosis of the tumor is often difficult, and our diagnostic rate was 45.5%. Now, VCE has a limitation in terms of detailed diagnosis and the improvement of the mechanical systems. The complications of VCE are aspiration and retention of VCE. The aspiration is rare, but retention occurs in 1-2% of the cases. Preventive care is important. VCE will be a reliable procedure in future for small bowel disorders together with double balloon endoscopy, detailed diagnosis and therapeutic procedure introduced in 2001.