Capsule endoscopy for detection of small bowel malignancies.

Capsule Endoscopy (CE) is a recent diagnostic tool for detection of small bowel disease. The tiny imaging capsule has to be swallowed by the patient, which allows transmission by radiofrequency two images each second, to sensors worn around the patient's abdomen. After eight hours, the pictures can be downloaded and read by a Gastroenterologist. CE allows for exploration of the entire small bowel mucosa, which involves segments not accessible by classical endoscopy. Moreover, it is the only technique that involves a visualization of the entire small bowel without sedation. Tumors of the small intestine are rather infrequent and could account for approximately 2% of gastrointestinal neoplasms. As symptoms of small bowel tumors are not specific, most published series include patients with bleeding or anemia of undetermined origin, the main indication for performing CE. Currently, no doubt exists of the ability regarding the CE to increase the diagnostic yield of small bowel tumors, or to alter their management and improve their outcome in the absence of metastases. Overall, tumors along the small intestine are located by CE in 2.5%-8.9% of patients who undergo this procedure. While being an evident improvement, CE has some limitations, such as the inability to treat lesions locally or take tissue specimens. This last point is an important shortcoming, because small bowel tumors can be malignant (approximately 2/3 of the cases) or benign. The future of CE is bright, and special capsule devices already exist to specifically explore the esophagus as well as the large intestine.