Video capsule endoscopy: Perspectives of a revolutionary technique

Table 1 Video Capsule

	Pillcam				EndoCapsule	MiroCam	OMOM	Capso-vision
	Colon2	ESO2	SB2	SB3
Length	31	26	26	26	26	24	27.9	31
Weight, g	3.4	3.4	3.4	3	3.8	3.4	6	-
Number of imaging heads	2	2	1	1	1	1	1	4
Frames, s	4-35	14	2	2-6	2	3	2	12-20
Image sensor	CMOS	CMOS	CMOS		CCD	CCD	CCD	White LEDs
Battery life, h	10	30 min	8	≥ 11	9	11	8	15
Antennas	8	NA	8	8	8	9	14	Wire-free

LED: Light emitting diode; CMOS: Complementary-metal oxide semimiconductor; CCD: Charged coupled device.

Table 2 Small bowel capsule video endoscopy

Preparation

No preparation

Fasting since the day before

Clear liquid diet/a 8-h fast

Ingestion of PEG (1 or 2 L)

Simethicone

Indications

Obscure gastrointestinal bleeding

Crohn’s disease

Polyposis (FAP, Peutz-Jeghers…)

Coeliac disease

Intestinal tumors

SB mucosal breaks

Unsolved abdominal pain/diarrhea

Factors associated with a higher detection rate of positive findings

Early CE within the first days of admission for overt OGIB

Advanced age

Male sex

Inpatient status

Use of anticoagulation

Hepatic comorbidity

Occurrence of more than one episode of bleeding

Ongoing overt OGIB

Hemoglobin level of less than 10 g/dL

Coexistence of connective tissue disease

Need for a high number of transfusions before SBVCE

FAP: Familial adenomatous polyposis; OGIB: Obscure gastrointestinal bleeding; CE: Capsule endoscopy; SBVCE: Small bowel (SB) capsule video endoscopy; PEG: Polyethylene glycol.

Table 3 Obscure gastrointestinal bleeding: Reported risk factors for rebleeding

Hemoglobin level of less than 8 g/dL

Age over 70 yr

Presence of a significant lesion at SBVCE

Presence of angiectasis

Duration of OGIB for more than 3 mo

Continuation of anticoagulation

OGIB: Obscure gastrointestinal bleeding; SBVCE: Small bowel capsule video endoscopy.

Table 4 Colon capsule endoscopy: Major studies

Ref.	Patients with significant findings n (%)	Sensitivity	Specificity	PPV	NPV
CCE-1
Eliakim et al[102], 2006	16 (19)	50%	82%	40%	88%
Schoofs et al[103], 2006	13 (36)	77%	70%	59%	84%
Van Gossum et al[107], 2009	87 (27)	64%	84%	60%	86%
CCE-2
Eliakim et al[104], 2009	18 (19)	89%	76%	46%	97%
Spada et al[111], 2011	45 (41)	84%	64%	62%	85%

PPV: Positive predictive value; NPV: Negative predictive value; CCE: Colon capsule endoscopy.