Capsule Endoscopy and Deep Enteroscopy: Indications for the Practicing Clinician

Approximately 5% of patients presenting with acute or chronic gastrointestinal (GI) hemorrhage will have a responsible source located in the small intestine.1 For patients residing in the United States or Europe, lesions most responsible for small bowel hemorrhage include arteriovenous malformations in 30%–40%,2 ulcerations,3 other vascular disorders including Dieulafoy lesions,2 and small bowel neoplasms in 1%–3% of patients.4 In Japan and Asia, small bowel ulcerations and tumors are more likely to be causal.5 Historically, endoscopic access to the small intestine has been challenging because of the significant length of the small bowel, intraperitoneal location, contractility, and overlying loops.