• Bleeding per rectum
• Bowel arteriovenous malformation
• Lower gastrointestinal bleeding
• Obscure gastrointestinal bleeding

Wireless Capsule Endoscopy is a state-of-the-art technology for medical diagnoses of gastrointestinal diseases. The amount of data produced by an endoscopic capsule camera is huge. These vast amounts of data are not practical to be saved internally due to power consumption and the available size. So, this data must be transmitted wirelessly outside the human body for further processing. The data should be compressed and transmitted efficiently in the domain of power consumption. In this paper, a new approach in the design and implementation of a low complexity, multiplier-less compression algorithm is proposed. Statistical analysis of capsule endoscopy images improved the performance of traditional lossless techniques, like Huffman coding and DPCM coding. Furthermore the Huffman implementation based on simple logic gates and without the use of memory tables increases more the speed and reduce the power consumption of the proposed system. Further analysis and comparison with existing state-of-the-art methods proved that the proposed method has better performance.

• ASIC
• DPCM
• FPGA
• FinFet
• RTL
• cadence
• encounter
• huffman
• lossless image compression
• low-complexity
• low-power consumption
• multiplier-less
• subtraction
• wireless capsule endoscopy

• gastroenterography
• low dose
• multidetector computed tomography
• oral contrast medium

• Capsule endoscopy
• Computed tomography enterography–angiography
• Intra-operative enteroscopy
• Non-variceal gastrointestinal bleed
• Tc99m pertechnetate scan

• Enteroscopy
• Hemorrhage
• Obscure hemorrhage
• Small bowel bleeding
• Upper gastrointestinal bleeding

Gastrointestinal bleeding from non-Meckel’s small bowel diverticulosis is uncommon. Depending on the diverticulum’s location, a patient’s presentation can suggest either an upper or lower gastrointestinal source. We present two cases of bleeding from non-Meckel’s small bowel diverticula. One patient was managed successfully with endoscopic therapy, and the second required surgical resection after two failed attempts at achieving hemostasis endoscopically.

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Jejunal diverticular disease is rare in Africa.

Diverticular disease is uncommon among Africans though increasing number of cases is now being reported, mainly of colonic diverticulosis. This condition afflicts all parts of the gastrointestinal tract but commonly the colon. Jejunal diverticula are rare, usually asymptomatic but may lead to an acute abdomen.

A 68 year old female trader, who was referred from a peripheral center with insidious onset of severe colicky, generalized abdominal pain, repeated vomiting of recently ingested meal, no hematemesis. There was constipation and abdominal distension. The working diagnosis was dynamic intestinal obstruction of small bowel origin.

She had emergency exploratory laparotomy following resuscitation. The findings were: volvulus of the jejunum and multiple jejunal diverticula. A resection of 80 cm of the jejunum with most of the diverticula involved in the torsion was done with an end-to-end anastomosis of the jejunum. Her out-patient follow-up has been uneventful.

Jejunal diverticular disease is rare in Africa. Our patient presented with small bowel obstruction due to volvulus. Other complications are discussed.

Intestinal obstruction from diverticular disease is not always of colonic origin. It can occur in the jejunum.

• Diverticula
• Jejunum
• Volvulus

Obscure gastrointestinal bleeding (OGIB) is defined as recurrent or persistent bleeding or presence of iron deficiency anaemia after evaluation with a negative bidirectional endoscopy. OGIB accounts for 5% of gastrointestinal bleeding and presents a diagnostic challenge. Current modalities available for the investigation of OGIB include capsule endoscopy, balloon assisted enteroscopy, spiral enteroscopy and computed tomography enterography. These modalities overcome the limitations of previous techniques. Following a negative bidirectional endoscopy, capsule endoscopy and double balloon enteroscopy remain the cornerstone of investigation in OGIB given their high diagnostic yield. Long-term outcome data in patients with OGIB is limited, but is most promising for capsule endoscopy. This article reviews the current literature and provides an overview of the clinical evaluation of patients with OGIB, available diagnostic and therapeutic modalities and long-term clinical outcomes.

• Obscure gastrointestinal bleeding
• Capsule endoscopy
• Double balloon enteroscopy
• Outcomes
• Anaemia

Obscure gastrointestinal bleeding is still a clinical challenge for gastroenterologists. The recent development of novel technologies for the diagnosis and treatment of different bleeding causes has allowed a better management of patients, but it also determines the need of a deeper comprehension of pathophysiology and the analysis of local expertise in order to develop a rational management algorithm. Obscure gastrointestinal bleeding can be divided in occult, when a positive occult blood fecal test is the main manifestation, and overt, when external sings of bleeding are visible. In this paper we are going to focus on overt gastrointestinal bleeding, describing the physiopathology of the most usual causes, analyzing the diagnostic procedures available, from the most classical to the novel ones, and establishing a standard algorithm which can be adapted depending on the local expertise or availability. Finally, we will review the main therapeutic options for this complex and not so uncommon clinical problem.

• Obscure gastrointestinal bleeding
• Angiodysplasia
• Wireless capsule endoscopy
• Double balloon enteroscopy

Capsule endoscopy is a new technology that, for the first time, allows complete, non-invasive endoscopic imaging of the small bowel. The efficacy of capsule endoscopy in the diagnosis of suspected small bowel diseases has been established. Important applications for surgeons include observations of obscure gastrointestinal bleeding and small bowel neoplasms.

• Capsule endoscopy
• Surgery
• Small bowel neoplasm
• Obscure gastrointestinal bleeding
• Angiodisplasia

• Capsule Endoscopy
• Digestive System Surgical Procedures
• Gastrointestinal Hemorrhage/diagnosis
• Gastrointestinal Hemorrhage/surgery
• Humans
• Intestinal Diseases/diagnosis
• Intestinal Diseases/surgery
• Intestinal Neoplasms/diagnosis
• Intestinal Neoplasms/surgery
• Intestine, Small/pathology
• Intestine, Small/surgery
• Patient Selection
• Practice Guidelines as Topic

• Capsule Endoscopy
• Gastrointestinal Hemorrhage/diagnosis
• Gastrointestinal Hemorrhage/etiology
• Gastrointestinal Hemorrhage/surgery
• Hemostasis, Surgical/methods
• Humans
• Postoperative Care/methods
• Preoperative Care/methods
• Prognosis

AIM: To evaluate the role of capsule endoscopy in determining the route for double-balloon enteroscopy.

METHODS: Twenty patients with negative or equivocal evaluation after capsule endoscopy received double-balloon enteroscopy (under anesthesia with propofol) by oral or anal route. The choice of the insertion route of the endoscope for the first attempt at double-balloon enteroscopy was made according to a time index (the value of the time in minutes for transit of the capsule endoscope from the pylorus to the lesion divided by the value of the time for transit of the capsule endoscope from the pylorus to the cecum). An anal route was indicated when the time index was more than 0.50. A second procedure was undertaken through the alternative route several days later when the lesion of interest was not found during the first one. The accuracy for choosing the route of double-balloon enteroscopy according to the capsule time index was then analyzed.

RESULTS: Five patients with negative evaluation after capsule endoscopy received double-balloon enteroscopy, and a lesion was detected in 1 of these patients when a second procedure by the anal route was performed. Fifteen patients with equivocal evaluation after capsule endoscopy received double-balloon enteroscopy, and the suspected findings were confirmed in 12 (80.0%) of these patients by double-balloon enteroscopy combined with pathological examination. An anal route of the endoscopy at the first attempt with double-balloon enteroscopy was selected on 4 patients (0.99, 0.8, 0.65, and 0.59, respectively), and the lesions were detected in the latter two (with a time index of 0.65 and 0.59, respectively) when a second procedure by the oral route was performed. If the time index of more than 0.75 (with consideration of another report) was used, no further attempts would be needed in these two patients, and the lesions of the other two patients were assumed to be located in the distal ileum and reached by double-balloon endoscopy via anal route exactly.

CONCLUSION: The outcome of capsule endoscopy can direct the choice of routes for double-balloon enteroscopy. A time index of more than 0.75 appears to indicate an anal route as the first procedure.

• Capsule endoscopy
• Double-balloon enteroscopy
• Anal route
• Oral route

• Acute Disease
• Adult
• Arthritis, Rheumatoid/complications
• Arthritis, Rheumatoid/diagnosis
• Diagnosis, Differential
• Female
• Humans
• Male
• Medical Records

• Aged
• Carcinoma, Small Cell/diagnostic imaging
• Carcinoma, Small Cell/pathology
• Carcinoma, Small Cell/secondary
• Carcinoma, Small Cell/surgery
• Fatal Outcome
• Humans
• Intestinal Neoplasms/diagnostic imaging
• Intestinal Neoplasms/secondary
• Intestinal Neoplasms/surgery
• Intestine, Small/surgery
• Lung Neoplasms/diagnostic imaging
• Lung Neoplasms/pathology
• Male
• Survival
• Time Factors
• Tomography, X-Ray Computed