Background: In the medical literature, the nomenclature and descriptions (ND) of small bowel (SB) ulcerative and inflammatory (U‐I) lesions in capsule endoscopy (CE) are scarce and inconsistent. Inter‐observer variability in interpreting these findings remains a major limitation in the assessment of the severity of mucosal lesions, which can impact negatively on clinical care, training and research on SB‐CE.Objective: Focusing on SB‐CE in Crohn’s disease (CD), our aim is to establish a consensus on the ND of U‐I lesions.Methods: An international panel of experienced SB‐CE readers was formed during the 2016 United European Gastroenterology Week meeting. A core group of five CE and inflammatory bowel disease (IBD) experts established an Internet‐based, three‐round Delphi consensus but did not participate in the voting process. The core group built illustrated questionnaires, including SB‐CE still frames of U‐I lesions from patients with documented CD. Twenty‐seven other experts were asked to rate and comment on the different proposals for the ND of the most frequent SB U‐I lesions. For each round, we used a 6‐point rating scale (varying from ‘strongly disagree’ to ‘strongly agree’). The consensus was reached when at least 80 % of the voting members scored the statement within the ‘agree’ or ‘strongly agree’ categories.Results: A 100% participation rate was obtained for all the rounds. Consensual ND were reached for the following seven U‐I lesions: aphthoid erosion, deep ulceration, superficial ulceration, stenosis, edema, hyperemia anddenudation.Conclusion: Considering the most frequent SB U‐I lesions seen in CE in CD, a consensual ND was reached by the international group of experts. These descriptions and names are useful not only for daily practice and medical education, but also for medical research.

Background and study aims Capsule endoscopy (CE) is the preferred method for small bowel (SB) exploration. With a mean number of 50,000 SB frames per video, SBCE reading is time-consuming and tedious (30 to 60 minutes per video). We describe a large, multicenter database named CAD-CAP (Computer-Assisted Diagnosis for CAPsule Endoscopy, CAD-CAP). This database aims to serve the development of CAD tools for CE reading. Materials and methods Twelve French endoscopy centers were involved. All available third-generation SB-CE videos (Pillcam, Medtronic) were retrospectively selected from these centers and deidentified. Any pathological frame was extracted and included in the database. Manual segmentation of findings within these frames was performed by two pre-med students trained and supervised by an expert reader. All frames were then classified by type and clinical relevance by a panel of three expert readers. An automated extraction process was also developed to create a dataset of normal, proofread, control images from normal, complete, SB-CE videos. Results Four-thousand-one-hundred-and-seventy-four SB-CE were included. Of them, 1,480 videos (35 %) containing at least one pathological finding were selected. Findings from 5,184 frames (with their short video sequences) were extracted and delimited: 718 frames with fresh blood, 3,097 frames with vascular lesions, and 1,369 frames with inflammatory and ulcerative lesions. Twenty-thousand normal frames were extracted from 206 SB-CE normal videos. CAD-CAP has already been used for development of automated tools for angiectasia detection and also for two international challenges on medical computerized analysis.

Background and Aim: Pan-enteric capsule endoscopy [PCE] is a highly sensitive but time-consuming tool for detecting pathology. Artificial intelligence [AI] algorithms might offer a possibility to assist in the review and reduce the analysis time of PCE. This study examines the agreement between PCE assessments aided by AI technology and standard evaluations, in patients suspected of Crohn’s disease [CD]. Method: PCEs from a prospective, blinded, multicentre study, including patients suspected of CD, were processed by the deep learning solution AXARO® [Augmented Endoscopy, Paris, France]. Based on the image output, two observers classified the patient’s PCE as normal or suggestive of CD, ulcerative colitis, or cancer. The primary outcome was per-patient sensitivities and specificities for detecting CD and inflammatory bowel disease [IBD]. Complete reading of PCE served as the reference standard. Results: A total of 131 patients’ PCEs were analysed, with a median recording time of 303 min. The AXARO® framework reduced output to a median of 470 images [2.1%] per patient, and the pooled median review time was 3.2 min per patient. For detecting CD, the observers had a sensitivity of 96% and 92% and a specificity of 93% and 90%, respectively. For the detection of IBD, both observers had a sensitivity of 97% and had a specificity of 91% and 90%, respectively. The negative predictive value was 95% for CD and 97% for IBD. Conclusions: Using the AXARO® framework reduced the initial review time substantially while maintaining high diagnostic accuracy—suggesting its use as a rapid tool to rule out IBD in PCEs of patients suspected of Crohn’s disease.

Precise history (type of foreign body, time of onset) is essential. Physical examination is also mandatory. Most patients are asymptomatic. Symptoms arise when the foreign body is stuck in the oesophagus or when a complication occurs (obstruction and perforation).9 Emesis, retching, blood-stained saliva, hypersialorrhoea, wheezing and/or respiratory distress in non-communicative patients (children and psychiatric patients) are suggestive of foreign body impaction.7 Oesophageal impaction (food bolus) is often symptomatic: retching, …