Small Bowel Video Capsule Endoscopy

An Overview

Barzin F Mustafa; Mark Samaan; Louise Langmead; Mustafa Khasraw


Expert Rev Gastroenterol Hepatol. 2013;7(4):323-329. 

In This Article

Capsule Aspiration

There are published case reports of endobronchial aspiration of the endoscopy capsule.[35] This could potentially be life threatening. If the patient is unable to spontaneously cough it up, immediate bronchoscopic extraction may be required. Patients with comorbidities related to brain injury or chronic obstructive pulmonary disease may be at increased risk. It has been suggested to consider endoscopic placement of the capsule directly into the GI tract for this subgroup.


In general terms, CE is an expensive procedure in comparison to other investigations, such as BFT or radiological investigations, but in some diseases, and in cases where it may take a very long time to reach a diagnosis, it may be more cost effective than other tools of investigation from a health–economic perspective. An example of that is in the case of suspected Crohn's disease, where sometimes it takes more than a year between the appearance of symptoms and definite diagnosis, and requires the continual repetition of radiological investigation and ileo–colonoscopies, in addition to frequent hospitalization and clinic visits. The total costs in these select cases far outweigh the cost of the VCE. Using VCE, small bowel lesions can be seen and the procedure can help in reaching an earlier diagnosis.[36]

Other Limitations

In video CE, only the intestinal lumen can be visualized. Biopsy or any therapeutic procedure cannot be performed. For these indications where tissue is required, DBE can be considered as an alternative option to VCE.[36] Another point is lack of standard language or an index to describe lesions visualized by the test. Studies that have been conducted have each used their own parameters for severity and for describing the lesions. To address this, serious efforts have been made in the last few years to devise a standard index for describing the findings during VCE, including inflammations, ulcers, stenosis, strictures and papillary appearances.[37]

Lastly, some technical problems may occur during the VCE procedure, such as short battery life and unclear videos. However, these complications are rarely seen these days due to the substantial developments in technology.[9]