[Surgical treatment of small intestinal diseases, causing hemorrhage, and diagnosed with capsule endoscopy]

The wireless video capsule endoscopy is a new, painless, non-invasive technique for imaging the small bowel. It can be used to visualise the entire small bowel in selected patients where bleeding source cannot be verified by conventional diagnostic methods. Authors operated on three patients between November 2002 and March 2003, after intestinal bleeding source was detected by capsule endoscopy. The conventional diagnostic techniques could not provide correct diagnosis. The first patient, a 63-year-old man underwent right hemicolectomy one year earlier because of to colonic cancer. The source of bleeding was local recurrence penetrating into small bowel. The second patient, a 56-year-old woman underwent small bowel resection because of Meckel diverticulitis more than 30 years ago. By capsule endoscopy an ulcer was detected in the anastomosis. In the third case--a 60-year-old woman--an ulcerated leiomyoma was found in the first jejunal loop, next to the duodeno-jejunal flexure. In all the three patients resection was performed. The postoperative periods were uneventful. All patients are free of symptoms since the procedure. Capsule endoscopy was able to localise the source of intestinal bleeding, when conventional diagnostic methods were ineffective.