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Esophageal tumor diagnosed by capsule endoscopy.

A 74-year-old man was referred to our unit with a 3-year history of typical heartburn symptoms. His heartburn had became refractory to treatment with proton pump inhibitors in the 3 weeks prior to presentation but it was not accompanied by dysphagia, anemia, hematemesis, or weight loss. He was recommended to have an upper gastrointestinal endoscopy but he refused to undergo this examination. After much discussion, he was offered the option of esophageal capsule endoscopy, with the proviso that if any abnormal finding was observed he would require standard upper gastrointestinal endoscopy. The patient swallowed the video capsule (PillCam ESO; Given Imaging, Yoqneam, Israel) without problems and the study lasted for 20 minutes and 23 seconds, during which time the capsule did not pass into stomach (although capsule excretion was confirmed later). The capsule study revealed a polypoid lesion in the mid-esophagus (Figure 1, Video 1), as well as mucosa distal to the polyp that resembled gastric mucosa and was consistent with a diagnosis of Barrett s esophagus.