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Background and Objective: The video-capsule endoscopy (CE) of the small intestine is a novel innovative procedure for outpatient use that can detect even small lesions of the mucosa of the small intestine. Aim of this retrospective clinical study was to evaluate the diagnostic value of CE in a clinical routine setting., Patients and Methods: Between July 2001 and October 2002 we investigated 42 patients with suspected gastrointestinal bleeding by CE. In all patients, the previous upper and lower endoscopy work-up was normal. In some cases additional procedures such as bloodpool scintigraphy, angiography, small-bowel enteroclysis or push-enteroscopy were performed., Results: CE detected relevant pathological findings in 23 out of 42 Patients (55 %). The majority of findings in the CE consisted of angiodysplasia (n = 16), ulcer and haemorrhagical erosions (n = 10), one Ulcus Dieulafoy and additional polyps of the small intestine (n = 2). In 4 cases an inflammatory small-bowel disease was detected. These findings could be confirmed by Re-endoscopy. The information provided was helpful to direct further diagnostic and treatment options. In 14 cases (33 %) CE-findings steered additional diagnostic and therapeutic steps. We conclude that CE is safe and has a high diagnostic yield., Conclusion: M2A video CE is likely to become an integral part of the algorithm of diagnostic of occult gastrointestinal bleeding after exclusion of other causes of anemia and negative upper and lower endoscopy work-up.

The results of the 1098 responses to a questionnaire show a remarkable increase in the use of intra-uterine devices (IUD) as a method of contraception (especially in the last 3 years) in the FRG too. The main reasons for the insertion of IUD were specified as "incompatibility" with the pill or "weariness induced through constant use of the pill". IUD are also used by nulliparae. At the moment T-shaped models containing copper are most popular. The majority of insertions are performed without general anaesthesia. The optimal length of time for wearing an IUD is considered to be 2 years or more. The foremost reasons for removal of IUD are bleeding or pain. Failures (pregnancies) however, are rather frequently recorded. Most gynecologists remove the IUD if pregnancy has occurred and in this case only few of them try to maintain the pregnancy on the patients request. In 1976, the majority of gynecologists attended patients composed of 40 : 1 users of the pill : users of IUD. Numerically speaking therefore, IUD are the method which actually takes second place. In our opinion however, if attention is paid to indications and contra-indications and to the necessity for intensive education of the patient, IUD are a real alternative to the pill and to the increasing use of any type of female sterilization.