In IDA patients ≤50 years with negative bidirectional GI endoscopy, overall DY of SBCE for clinically significant findings was 32.3%. Some 5% of our cohort was diagnosed with SB neoplasia; lower MCV or weight loss were associated with higher DY for SB pathology.

Capsule endoscopy (CE) has proved to be an important non-invasive tool for diagnosis and monitoring Crohn’s disease patients. It has the advantage of excellent visualization of digestive tract mucosa, a good tolerability and safety in well-selected patients. The risk of retention can be diminished by good selection of patients using imaging techniques and by the use of patency capsule. The aim of a capsule examination is not only an early diagnosis but also a very good stratification of prognosis, thus directing the treatment strategy for either a step up or top-down approach and also permitting the optimization of the treatment depending on the findings. When symptoms and biomarkers point to a change in the disease’s activity we can either adjust the treatment directly as recommended in CALM study or choose in selected patients to visualize the digestive mucosa through a CE and take a decision afterwards. The appearance of the new capsule from Medtronic-the Pillcam Crohn’s might be an important step forward in diagnosis, evaluating disease extent, the severity of the disease, prognosis, management in a treat to target approach, with treatment modifications according to the data from CE examination. Serial examinations in the same patient can be compared and a more objective evaluation of the lesions modification from one exam to another can be performed. We present the latest developments and current status and evidence that in selected patients capsule can be a tool in a treat to target approach.

BackgroundGastrointestinal stromal tumors are a subtype of mesenchymal tumors. In recent years a significant progress was made in their diagnosis and treatment which led to significant improvement of their prognosis. Endoscopy remains one of the main diagnostic methods. In the rare instance of colonoscopy failure, different approaches are available: different endoscope, computed tomography colonography, capsule endoscopy, use of an enteroscope.Case presentationWe present the case of a 75-year-old Caucasian man admitted for abdominal pain, diarrhea and weight loss. Two colonoscopy attempts failed in a different center and a decision to use colon capsule endoscopy was made. This exam revealed a submucosal mass located in the sigmoid colon. Surgery was performed and a local invading gastrointestinal stromal tumor was removed. This is the first image of a colonic gastrointestinal stromal tumor seen on capsule endoscopy.ConclusionColon capsule is a useful diagnostic tool in selected patients after colonoscopy failure or contraindication.

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Introduction: In inflammatory bowel disease uncontrolled inflammation may play a role in the early progression of systemic atheromatosis with increased cardiovascular risk. Endothelial dysfunction is mediated by pro-inflammatory cytokines but also by an increased level of CRP which is involved in the expression of adhesion molecules and atheroma plaque rupture. Tailored treatment with better control of the ulcerative colitis and endoscopic healing might result in decrease risk of atherothrombotic events. Aim: We decided to use a well-established method (vascular Doppler ultrasound with media-intimate index measurement) to detect an increased incidence of endothelial lesions as predictors of early atheromatosis in patients with ulcerative colitis treated with biological or conventional therapy. Material and methods: We prospectively analyzed 25 patients with RCUH with a mean age of 40 years, 16 with biological treatment. The Student t test, the Mann Whitney U test and the ANOVA test were used to compare continuous variables. Results: A discriminant analysis was performed with the presence of atheroma plaque as a dependent variable and several predictor variables, such as age, triglycerides, cholesterol of patients with ulcerative colitis. Univariate ANOVA analyzes revealed that the presence or absence of atheroma plaque differs in the variables predicting the age, INR and ecoIMT of patients with ulcerative colitis (in the age of patients (F = 8.511, degrees of freedom = 11, p = 0.014) Patients ‚INR (F = 50,437, degrees of freedom = 11, p = 0.001) and Patients’ ecoIMT (F = 7,398, degrees of freedom = 11, p = 0.020) In another analysis of discriminatory function s -introduced the predictor variables specific to measuring the evolution of ulcerative colitis, respectively Mayo and Mayo E (age (F = 0.8511, degrees of freedom = 11, p = 0.014), INR (F = 50.437, degrees of freedom = 11, p = 0.001), ecoIMT (F = 7.398, df = 11, p = 0.020) and Mayo (F = 14.885, degrees of freedom = 11, p = 0.003). Conclusions: Age, endoscopic activity, and INR were correlated with predictive ultrasound changes for atheromatosis. Strengths are the prospective nature of the study and weaknesses are the limited number of patients and the fact that most patients were in remission and treated with biologicals, which could create bias in the sense of reducing the atherosclerotic risk directly correlated with active inflammation.