Capsule Endoscopy: A Cause of Late Small Bowel Obstruction and Perforation

Skovsen, Anders Peter; Burcharth, Jakob; Burgdorf, Stefan Kobbelgaard

doi:10.1155/2013/458108

Cited by 16 publications

(16 citation statements)

References 7 publications

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“…The role of MRI in predicting capsule retention in the small bowel is still unclear, as it seems that it sometimes overstages and loses small bowel strictures. In fact, some false negatives and positives of MRI have been recently reported (29,30). On the other hand, capsule retention after a negative capsule patency examination is rare as showed by our paper and other articles (31)(32)(33).…”

Section: Discussionsupporting

confidence: 53%

Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population

Fernández-Urién¹,

Carretero²,

González³

et al. 2015

Rev Esp Enferm Dig

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Introduction: Capsule endoscopy (CE) has become a first-line tool for small bowel (SB) examination. However, adverse events (AEs), such as CE retention or aspiration, may occur. The aims of this study were to evaluate incidence, clinical outcomes and therapeutic approaches of CE-related AEs in the largest series published to date.Methods: Data from 5428 procedures performed at 12 institutions between August 2001 and January 2012 were retrospectively analyzed. Baseline patient characteristics; procedure; type, localization and symptoms before/after AEs; previous patency tests performed; therapeutic management and patient´s outcome were recorded.Results: The overall incidence of CE-related AEs was 1.9%: 2.0% for SB, 0.9% for esophageal and 0.5% for colon CE. The incidence of capsule retention was significantly higher than capsule aspiration (1.87% vs. 0.003%; p < 0.05), in patients suffering from inflammatory bowel disease (IBD) than in obscure GI bleeding (OGIB) (3.3% vs. 1.5%; p < 0.05) and in patients with the combination of nausea/vomiting, abdominal pain and distension. The SB was the most frequent localization of retention (88.2%). The use of patency tests -except for Patency © capsule-before CE was not a good predictor for AEs. Most of the patients with AEs developed no or mild symptoms (97%) and were managed by non-surgical methods (64.4%).Conclusions: CE-related AEs are uncommon and difficult to predict by imagiological examinations. SB retention, that is usually asymptomatic, is the most frequent AE. In absence of symptoms, non-surgical management of CE-related AEs is recommended.

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Section: Discussionsupporting

confidence: 53%

Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population

Fernández-Urién¹,

Carretero²,

González³

et al. 2015

Rev Esp Enferm Dig

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“…Although there were many reports of capsule retention of long duration [ 4 , 12 , 13 ], we think that the retained CE should be retrieved if spontaneous or pharmaceutical manipulation, the rates of spontaneous or pharmaceutical-manipulated passage of retained capsules have been reported to vary from 15 to 65.6% [ 3 , 14 ], is ineffective to egest it because there are several reports of retained capsule causing intestinal obstruction and perforation [ 5 , 6 , 8 , 9 ]. Surgical retrieval is often required secondary to an underlying pathologic process causing a stricture or obstruction although double-balloon endoscopy has been reported as one of the effective approaches for the retrieval of retained CE [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Unawareness of a Prolonged Retained Capsule Endoscopy: The Importance of Careful Follow-Up and Cooperation between Medical Institutions

Saigusa

Ohi

Imaoka

et al. 2014

Case Reports in Gastrointestinal Medicine

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A 50-year-old man with anemia was referred to our hospital to undergo capsule endoscopy (CE), which revealed small intestinal ulcers. After 5 months of CE, he returned because of recurrent anemia without abdominal symptoms. Abdominal X-ray and computed tomography showed capsule retention in the small intestine at the pelvic cavity. The capsule remained at the same place for 7 days. We performed capsule retrieval by laparoscopy-assisted surgery with resection of the involved small intestine, including an ileal stricture. Resected specimen showed double ulcers with different morphologies, an ulcer scar with stricture, and a wide ulcer at the proximal side of the others. Each ulcer had different histopathological findings such as the degree of fibrosis and monocyte infiltration. These differences led us to consider that the proximal ulcer may have been secondarily induced by capsule retention. Our experience indicated that careful follow-up and the cooperation between medical institutions after CE examination should be undertaken for patients with incomplete examination, unknown excretion of the capsule, and/or ulcerative lesions despite the lack of abdominal symptoms. Additionally, a retained CE remaining over long periods and at the same place in the small intestine may lead to secondary ulceration.

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“…Although most cases of symptomatic capsule retention occur close to the time of capsule ingestion late cases of capsule retention-induced bowel obstruction has been reported. For example, in one case reported a 71-year-old man presented with acute intestinal obstruction and perforation six months after capsule ingestion (14). The majority of capsule retentions remain asymptomatic even for a longer time.…”

Section: Discussionmentioning

confidence: 99%

Colonic obstruction caused by video capsule entrapment in a metal stent

Tóth¹,

Marthinsen²,

Bergström³

et al. 2017

Ann. Transl. Med.

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Video capsule endoscopy (VCE) has become the method of choice for visualizing the small bowel mucosa and is generally considered to be a safe method. Although uncommon, the most feared complication of VCE is capsule retention that can potentially lead to life-threatening bowel obstruction. Herein, we present for the first time a case of capsule retention in a colonic stent. The patient had known Crohn's disease with colonic involvement and underwent an uneventful but incomplete small bowel VCE for assessment of disease activity and extension for optimizing medical treatment. Five months later, the patient presented with intestinal obstruction due to a Crohn's-stricture in the sigmoid colon, which was successfully decompressed with a self-expandable metal stent. Nonetheless, two days later the patient showed signs of bowel obstruction again and abdominal X-ray showed that the capsule was trapped in the metal stent in the sigmoid colon. Subsequently, emergency surgery was performed and the patient fully recovered. Intestinal capsule retention necessitating interventional removal is rare. This report describes a unique case of capsule retention in a colonic metal stent and highlights the potential risk of performing capsule endoscopy examinations in patients with gastrointestinal stents.

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Capsule Endoscopy: A Cause of Late Small Bowel Obstruction and Perforation

Cited by 16 publications

References 7 publications

Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population

Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population

Unawareness of a Prolonged Retained Capsule Endoscopy: The Importance of Careful Follow-Up and Cooperation between Medical Institutions

Colonic obstruction caused by video capsule entrapment in a metal stent

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