Distinguishing Normal Anatomy from Abnormal Capsule Endoscopic Images: A Challenging Task

Abstract

Reading and interpreting capsule endoscopic images is a skill similar to interpreting standard video endoscopic images. First, it requires the reader to understand and recognize what is normal before being able to detect, identify, and interpret what is abnormal. In addition, the reader should have a thorough understanding of the various diseases of the small bowel and their respective endoscopic/capsule endoscopic presentations. If one does not know what to look for, then one will never find it. However, unlike conventional endoscopy that enables the gastroenterologist to not only observe but to also touch and sample pathologic findings, with capsule endoscopic evaluation, the endoscopist is simply an observer without the ability to manipulate the movement of the capsule, insufflate the bowel lumen, lavage the mucosa, or sample a suspicious finding. This chapter aims to familiarize the reader with normal anatomy, with common pathologies, and also with common findings that one may see that are not pathologic, but rather incidental, yet important to recognize.