• Taha Ahmed Al-Karbuli Department of Medicine, School of Medicine, University of Sulaimani, Kurdistan Center for Gastroenterology and Hepatology, Sulaimani, Kurdistan Region, Iraq.
  • Hiwa A Hussein Kurdistan Center for Gastroenterology and Hepatology, Sulaimani, Kurdistan Region, Iraq.
  • Ali A Ramadhan Kurdistan Center for Gastroenterology and Hepatology, Sulaimani, Kurdistan Region, Iraq.
  • Sabir M Ameen Department of Medicine, School of Medicine, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq.



Video capsule endoscopy, Small intestine, Sulaimani



The small intestine is the most difficult part of the intestine to examine. Video capsule endoscopy has revolutionized the study of the small intestine. Since its availability, no local data are available to optimize the use of this valuable diagnostic procedure.


To review the indications, diagnostic yield and safety of video capsule endoscopy in a tertiary referral center.

Patients and Methods

This retrospective descriptive study was done in Kurdistan Center for Gastroenterology and Hepatology in Sulaimani City from June 2009 to February 2012. A total of 43 patients underwent video capsule endoscopy during this period (18 females, 25 males) with their age ranging from 9 years to 87 years (mean=37 years).


Indications of video capsule endoscopy were obscure gastrointestinal hemorrhage (N.=20, diagnostic yield=70%), suspicion of Crohn's disease (N.=11, diagnostic yield=64%), chronic abdominal pain (N.=8, diagnostic yield=50%), small intestinal polyposis syndrome (N.=2, diagnostic yield = 100%) and chronic unexplained diarrhea (N.=2, diagnostic yield=0%). The most common finding was gastrointestinal erosions and/or ulcers (N. = 21, 48.9%). No capsule retention has been recorded.


Video capsule endoscopy is safe and has an acceptable diagnostic yield in obscure gastrointestinal hemorrhage, Crohn's disease and small intestinal polyposis syndrome. However, more studies are warranted to establish the impact of these diagnostic yields on patient outcome rates.


Fireman Z, Glukhovsky A, Jacob H, Lavy A, Lewkowicz S, Scapa E. Wireless Capsule Endoscopy. IMAJ 2002;4:717-9.

Lin S, Shetzline M, Agrawal N. Capsule Endoscopy. Practical Gastroenterology 2004; XXVIII(3):13-33.

Rondonotti E, Villa F, Mulder CJ, Jacobs MA, de Franchis R. Small intestine capsule endoscopy in 2007: indications, risks & limitations. World J Gastroentero 2007; 13:6140–9. DOI:

Gay G, Delvaux M, Fassler I, Frédéric M, Penman I. Small bowel endoscopy: indications and technique. In: Canard JM, Létard JC, Palazzo L, Penman I, Lennon AM Editors. Gastrointestinal Endoscopy in

Practice. Edinburgh: Churchill Livingstone Elsevier. 2011; PP 123-31.

Sidhu R, Sanders DS, Mc Alindon ME. Gastrointestinal capsule endoscopy: from tertiary centres to primary care. BMJ 2006;332(7540):528-31. DOI:

Sidhu R, Sanders DS, Morris AJ, McAlindon ME. Guidelines on small bowel enteroscopy and capsule endoscopy in adults. Gut 2008; 57:125–136. DOI:

Cave D, Legnani P, de Franchis R, Lewis BS. ICCE consensus for capsule retention. Endoscopy 2005; 37:1065–7. DOI:

Ladas LD, Triantafyllou K, Spada C, Riccioni ME, Rey JF, Niv Y, et al. Recommendations (2009) on clinical use of video capsule endoscopy to investigate small-bowel, esophageal and colonic diseases. Endoscopy 2010; 42: 220–7. DOI:

Nakamura T, Terano A. Capsule endoscopy: past, present, and future. J Gastroenterol 2008;43:93–9. DOI:

Kornbluth A, Colombel JF, Leighton JA, Loftus E. ICCE Consensus for Inflammatory Bowel Disease. Endoscopy 2005;37:1051–4. DOI:

Waterman M, Eliakim R. Capsule enteroscopy of the small intestine. Abdom Imaging 2008;405. DOI:

Stigler S. Fisher and the 5% level. Chance 2008; 21(4):12. DOI:

Rey JF, Ladas S, Alhassani A, Kuznetsov K. Video capsule endoscopy: Update to guidelines (May 2006). Endoscopy 2006; 38: 1047-53. DOI:

Triester SL, Leighton JA, Leontiadis GI, Fleischer DE, Hara AK, Heigh RI, et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure

gastrointestinal hemorrhage. Am J Gastroenterol 2005;100:2407–18.

Saperas E, Dot J, Videla S, Alvarez-Castells A, Perez-Lafuente M, Armengol JR, et al. Capsule endoscopy versus computed tomographic or standard angiography for the diagnosis of obscure gastrointestinal hemorrhage. Am J Gastroenterol 2007;102:731–7. DOI:

Hartmann D, Schmidt H, Bolz G, Schilling D, Kinzel F, Eickhoff A, et al: A prospective two-center study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI hemorrhage. Gastrointest Endosc 2005; 61:826-32. DOI:

Bresci G, Parisi G, Bertoni M, Tumino E, Capria A. The role of video capsule endoscopy for evaluating obscure gastrointestinal hemorrhage: Usefulness of early use. J Gastroenterol 2005; 40:256-9. DOI:

May A, Wardak A, Nachbar L, Remke S, Ell C: Influence of patient selection on the outcome of capsule endoscopy in patients with chronic gastrointestinal hemorrhage. J Clin Gastroenterol 2005; 39:684-8. DOI:

Apostolopoulos P, Liatsos C, Gralnek IM, Kalantzis C, Giannakoulopoulou E, Alexandrakis G et al: Evaluation of capsule endoscopy in active, mild-to-moderate, overt, obscure GI hemorrhage. Gastrointest Endosc 2007; 66:1174-81. DOI:

Apostolopoulos P, Liatsos C, Gralnek IM, Giannakoulopoulou E, Alexandrakis G, Kalantzis C, et al: The role of wireless capsule endoscopy in investigating unexplained iron deficiency anemia after negative endoscopic evaluation of the upper and lower gastrointestinal tract. Endoscopy 2006; 38:1127-32. DOI:

Enns R, Mergener K, Brandabur J. Capsule endoscopy (CE): A multicenter, international review and comparison of capsule studies done in three different tertiary care centers. Gastrointest Endosc 2003; 57:AB101.

Fireman Z, Eliakim R, Adler S, Scapa E. Capsule endoscopy (CE) in real life- A 4 centers experience of 160 consecutive patients in Israel. Gastrointest Endosc 2003; 57:AB85.

Fleischer DE, Leighton JA, Sharma VK, Heigh RI. Video capsule endoscopy (VCE) is useful in the evaluation of unexplained abdominal pain (AP). Gastroenterology 2003; 124:A-245. DOI:

Mata A, Llach J, Castells A, Rovira JM, Pellisé M, Ginès A et al. A prospective trial comparing wireless capsule endoscopy and barium contrast series for small-bowel surveillance in hereditary GI polyposis syndromes. Gastrointest Endosc 2005; 61: 721–5. DOI:

Caspari R, von Falkenhausen M, Krautmacher C, Schild H, Heller J, Sauerbruch T. Comparison of capsule endoscopy and magnetic resonance imaging for the detection of polyps of the small intestine in patients with familial adenomatous polyposis or with Peutz–Jeghersʼ syndrome. Endoscopy 2004; 36:1054–9. DOI:

Burke CA, Santisi J, Church J, Levinthal G. The utility of capsule endoscopy small bowel surveillance in patients with polyposis. Am J Gastroenterol 2005; 100: 1498–50. DOI:

Petroniene R, Dubcenco E, Baker JP, Ottaway CA, Tang SJ, Zanati SA et al. Given capsule endoscopy in celiac disease: evaluation of diagnostic accuracy and interobserver agreement. Am J Gastroenterol 2005; 100: 685-94. DOI:

Siegel LM, Stevens PD, Lightdale CJ, Green PH, Goodman S, Garcia-Carrasquillo RJ, et al. Combined magnification endoscopy with chromoendoscopy in the evaluation of patients with suspected malabsorption. Gastrointest Endosc 1997; 46: 226-30. DOI:

Westerhof J, Koornstra JJ, Hoedemaker RA , Sluiter WJ, Kleibeuker JH, Weersma RK. Diagnostic yield of small bowel capsule endoscopy depends on the small bowel transit time. World J Gastroenterol 2012; 18(13): 1502-7. DOI:

Delvaux M, Fassler I, Gay G. Obscure Digestive Hemorrhage (ODB): Validation of a diagnostic strategy integrating capsule enteroscopy (CE) as first line intestinal investigation. Gastrointest Endosc 2003; 57:AB162.

Katz D, Lewis B, Katz LB. Surgical experience following capsule endoscopy. Gastrointest Endosc 2003; 57:AB169.






How to Cite

Al-Karbuli T, Hussein H, Ramadhan A, Ameen S. VIDEO CAPSULE ENDOSCOPY: INDICATIONS, DIAGNOSTIC YIELD AND SAFETY IN SULAIMANI GOVERNORATE. JSMC [Internet]. 2013 Jun. 1 [cited 2024 Jul. 20];3(1):47-54. Available from:

Similar Articles

1-10 of 418

You may also start an advanced similarity search for this article.