Small Bowel Malignancies in Patients Undergoing Capsule Endoscopy for Iron Deficiency Anemia

Small bowel malignancies are rare and usually asymptomatic or symptoms are nonspecific. Therefore, small bowel tumors are difficult to diagnose. In patients with iron deficiency anemia (IDA) who have negative bidirectional endoscopy results, the small bowel may be considered the source of bleeding. However, in asymptomatic IDA patients with negative bidirectional endoscopy results, evidence supporting the routine use of capsule endoscopy (CE) is insufficient. CE can be considered in selected patients with recurrent or persistent IDA. The frequency of small bowel malignancies is low in patients undergoing CE for IDA, but the usefulness of CE for the diagnosis of small bowel malignancies in younger age groups with IDA has been reported. For patients with risk factors for small bowel malignancy, investigation of the small bowel should be considered. Efforts should be made to prevent adverse events, such as capsule retention or capsule aspiration, through meticulous history taking and endoscopic capsule delivery as necessary.

An Intelligent Wired Capsule for the Treatment of Helicobacter pylori

An endoscopic capsule is a miniaturized ingestible video camera used to acquire images of the gastrointestinal tract wirelessly. Being morphologically equivalent to any ingestible pill, they can be simply swallowed. Endoscopic capsules therefore present an inviting alternative to the traditional endoscope for the examination of the gastrointestinal tract as well for therapeutic purposes. Endoscopic capsules are considered a disruptive technology, as they have revolutionized the examination of the gastrointestinal tract in a relatively short time. The implementation of an active locomotion system can improve the performance of a capsule and, in the solution proposed in this paper, allows providing the capsule the needed power for therapeutic purposes. Alternative therapeutic solutions, based on optical solutions and capsule endoscopy can be applied to patients affected by Helicobacter pylori, a bacterium of the stomach that affects about half of the world population, mainly in developing countries. The infection can be asymptomatic or associated with slight symptomatology. In some cases, it can take to major pathologies or death. The literature reports results deriving from recent applications of photodynamic treatments to H. pylori. Specific wavelengths have been found to exhibit photo-killing capabilities toward the bacterium. Some solutions have been proposed based on the use of endoscopic devices and capsules capable of administering photodynamic therapy inside the stomach. The proposed treatments, however, are invasive and insufficient to achieve long-term eradication. In this work, the administration of photodynamic therapy is proposed, aimed at the eradication of H. pylori by means of an active endoscopic capsule with LED emission. The capsule design, in addition to the therapeutic module aimed at administering an appropriate light intensity at specific wavelengths already demonstrated in the literature, integrates an active locomotion system aimed at maximizing the efficiency of the treatment.

Ileal neuroendocrine tumor: diagnosis by endoscopic capsule

The diagnosis of neuroendocrine tumors of the small intestine is usually challenging. They are infrequent, and the clinical course is insidious with nonspecific manifestations. Routine endoscopic and abdominal imaging studies are more often unremarkable. Therefore, distant metastases are frequently detected at the time of diagnosis. The tumor markers chromogranin A, synaptophysin, and neuron-specific enolase, and capsule endoscopy, and device-assisted enteroscopy are useful resources to establish a diagnosis. The aim was to present a case of neuroendocrine tumor of small intestine diagnosed with base in findings of the capsule endoscopy and further open surgery.

Feature Point Tracking-Based Localization of Colon Capsule Endoscope

In large bowel investigations using endoscopic capsules and upon detection of significant findings, physicians require the location of those findings for a follow-up therapeutic colonoscopy. To cater to this need, we propose a model based on tracking feature points in consecutive frames of videos retrieved from colon capsule endoscopy investigations. By locally approximating the colon as a cylinder, we obtained both the displacement and the orientation of the capsule using geometrical assumptions and by setting priors on both physical properties of the intestine and the image sample frequency of the endoscopic capsule. Our proposed model tracks a colon capsule endoscope through the large intestine for different prior selections. A discussion on validating the findings in terms of intra and inter capsule and expert panel validation is provided. The performance of the model is evaluated based on the average difference in multiple reconstructed capsule’s paths through the large intestine. The path difference averaged over all videos was as low as 4±0.7 cm, with min and max error corresponding to 1.2 and 6.0 cm, respectively. The inter comparison addresses frame classification for the rectum, descending and sigmoid, splenic flexure, transverse, hepatic, and ascending, with an average accuracy of 86%.

Utility of the endoscopic capsule in the study of the patient with severe anemia due to probable gastrointestinal bleeding of occult origin

Among complementary tests requested for the unknown-origin iron deficiency patient, gastroscopy and colonoscopy are frequent. However, it is important to assess the need to perform other studies if an etiological diagnosis is not reached, among which the endoscopic capsule stands out. In this case report the endoscopic capsule was essential to establish the jejunal adenocarcinoma diagnosis in an early stage of the disease, allowing the patient to undergo a curative surgical treatment without necessity of other therapies.