Luminal view of an intussusception captured by capsule endoscopy.

A 6-year-old boy was investigated for iron-deficiency anemia refractory to oral supplementation. He did not have a history of abdominal pain or gastrointestinal bleeding, and stool microscopy was normal. Gastroscopy and colonoscopy were normal. To exclude an occult cause of gastrointestinal bleeding, a small-bowel capsule endoscopy (CE) was undertaken. The image/video ( http://links.lww.com/MPG/A42 ) is a luminal view of a nonobstructive intussusception occurring at 1 hour 30 minutes into the small-bowel CE. It was asymptomatic and was not associated with any visible mucosal irregularity or blood in the lumen. No lead point such as a polyp was visualised during the study, and further investigations included a normal barium contrast follow-through study. No cause of his anemia has been identified to date. Gastrointestinal obstruction is a contraindication to performing a CE and should be excluded with imaging or the use of a degradable, radio-opaque patency capsule except in certain circumstances. Several studies have looked at the diagnostic yield of small-bowel CE in pediatrics, and the capture of an intussusception on CE is a noteworthy event because it is a rare occurrence (1). Itisnotpossible toverify whetheranintussusceptionisantegradeorretrogradeunlessoneisabsolutelycertainofthecapsule’sorientation(thecapsulelenscanspin). In the present case the capsule passed through the intussusception with minimal delay, possibly reducing it with its passage. The smooth, moist surface suggests that there may be a bubble contributing the sheen seen in the image. useful teaching point because it visually demonstrates an intussusception occurring as a normal physiological occurrence. In younger children, intussusception thought to caused by lymphoid hyperplasia. In older children and adults pathological lead points may be responsible for the intussusception (2).Intussusceptionscan pain,bloody stool,and vomiting. Symptomatic intussusceptions can betreated pneumatically or surgically. Further investigations may be necessary to exclude a lead point such as adenitis, Peutz-Jeghers polyp, and carcinoma, if clinically indicated.