Diagnosis of small-bowel varices by capsule endoscopy.
BACKGROUND
Capsule endoscopy is being used increasingly to investigate GI bleeding of obscure origin and disorders of the small bowel.


METHODS
Four cases of small-bowel varices of various etiologies diagnosed by capsule endoscopy are described: a bleeding small-bowel varix because of hepatic portal hypertension, oozing small-bowel anastomotic or adhesion-related varices, small-bowel varices secondary to mesenteric vein thrombosis, and "idiopathic intestinal varices."


METHODS
Over a 12-month period, small-bowel varices were found in 4 of 46 patients (8.7%) who underwent capsule endoscopy for GI bleeding. Fresh blood adjacent to the varices was documented in 3 patients. The small-bowel varices had serpiginous or nodular shapes, with or without a bluish coloration. The variceal mucosa appeared mosaic-like, shining, or normal compared with surrounding mucosa.


CONCLUSIONS
Capsule endoscopy is invaluable for the diagnosis of small-bowel varices. It is highly sensitive for detection of fresh blood in the small bowel. Clinical suspicion, capsule endoscopy image recognition, and alertness during capsule endoscopy interpretation are keys to diagnosis.
Tang
Shou-jiang
SJ
Center for Therapeutic Endoscopy and Endoscopic, Oncology, St Michael's Hospital, University of Toronto, Ontario, Canada.
Zanati
Simon
S
Dubcenco
Elena
E
Cirocco
Maria
M
Christodoulou
Dimitrios
D
Kandel
Gabor
G
Haber
Gregory B
GB
Kortan
Paul
P
Marcon
Norman E
NE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D014648:Varicose Veins / Q000175:diagnosis*