Occult gastrointestinal bleeding: two eyes are better than one

Introduction

A 55-year-old woman was referred for investigation of an incidental iron deficiency anaemia (haemoglobin 97 g/L; ferritin 10 ug/L and mean cell volume 71.3 fL). The patient had no gastrointestinal symptoms. Upper gastrointestinal endoscopy was normal, with no evidence of coeliac disease on duodenal biopsies. Colonoscopy showed diverticulosis.

A capsule endoscopy was then performed, using a new generation dual camera capsule (Mirocam MC2000, Intromedic, Seoul, Korea). This utilises a charge coupled device camera at each end of the capsule, with software that allows the images from each camera to be viewed individually or in combination. Each camera records at three frames per second, and each has a 170° field of view. Compared with a single camera capsule endoscope, dual camera devices generate twice the coverage area of the small bowel, with faster frame acquisition rates.1

Small bowel images from capsule camera 1 were entirely normal (figure 1). A small bowel...

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