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Abstract: Background: Because it provides a direct view of superficial lesions in the small bowel, capsule endoscopy is a promising diagnostic tool for studying patients with suspected Crohn''s disease undetected by conventional modalities. Aim: To assess the role of capsule endoscopy in the diagnosis of patients with suspected Crohn''s disease. Patients and methods: Thirty-eight patients (16 males, mean age 46.2 years) with suspected Crohn''s disease but negative at conventional imaging were examined using capsule endoscopy. They were divided into 2 groups: 12 patients with ongoing symptoms (Group 1), and 26 with ongoing symptoms and biochemical markers of inflammation (Group 2). Capsule endoscopy findings were classified as diagnostic (multiple erosions/ulcerations), suspicious (≤3 erosions/ulcerations), non-specific and normal. Results: Capsule endoscopy findings were diagnostic for Crohn''s disease in 13 (34.2%) patients, suspicious in 2 (5.3%), non-specific in 4 (10.5%) and normal in 19 (50%), with an overall detection rate of 39.5%. The yield of positive findings was 8.3% in Group 1 and 46.2% in Group 2 (p =0.022). Capsule endoscopy findings prompted specific measures or patient management changes in 39.5% of patients. Conclusions: Capsule endoscopy has a high diagnostic yield in patients with suspected Crohn''s disease and both clinical and biochemical markers of inflammation. [Copyright &y& Elsevier]

Abstract: Blue rubber bleb nevus syndrome is a rare disorder characterised by cutaneous and gastrointestinal vascular malformations. A 31-year-old man came under our observation with obscure gastrointestinal bleeding. Hemangiomas on his back and the multiple bluish vascular lesions in the distal ileum revealed by capsule endoscopy led to the diagnosis of blue rubber bleb nevus syndrome. The patient was treated with octreotide to prevent rebleeding. During the 12 months of treatment he had no gastrointestinal bleeding episodes or anaemia. Then repeat capsule endoscopy showed that the small bowel vascular lesions were unchanged. Capsule endoscopy may be a useful tool for diagnosing and monitoring the effects of therapy in patients with blue rubber bleb nevus syndrome. [Copyright &y& Elsevier]