Case StudyClinically significant small-bowel pathology identified by double-balloon enteroscopy but missed by capsule endoscopy
Section snippets
Case 1
A 51-year-old woman, with a history of chronic abdominal pain since her teenage years, was recently diagnosed with celiac disease based on a small-bowel biopsy. A gastroscopy revealed a typical scalloped appearance of the small-bowel mucosa, but no other pathology was found. A colonoscopy was normal. She had 2 cousins with celiac disease, a sister diagnosed with colorectal cancer at age 27, and a paternal aunt with carcinoma of the pancreas. She had no other relevant medical history. She had no
Discussion
Investigation of the small bowel has been the last frontier for endoscopists. The arrival of CE early this decade represented a promising, novel, noninvasive, and well-tolerated method of examining the small bowel. Multiple studies have reported a higher yield by CE compared with conventional investigations, including push enteroscopy and small-bowel barium radiography in the investigation of OGB.1
However, CE is not without its limitations. Both false positive and negative results have been
Acknowledgments
We thank the referring gastroenterologists for their contribution of patients and to Dr Phil Baird for providing images for histology.
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