Capsule retention related to small bowel capsule endoscopy: a large European single‐center 10‐year clinical experience

Lim

et al. 2020

Sci Rep

Three-dimensional (3D) reconstruction of capsule endoscopic images has been attempted for a long time to obtain more information on small bowel structures. Due to the limited hardware resources of capsule size and battery capacity, software approaches have been studied but have mainly exhibited inherent limitations. Recently, stereo camera-based capsule endoscopy, which can perform hardwareenabled 3D reconstruction, has been developed. We aimed to evaluate the feasibility of newly developed 3D capsule endoscopy in clinical practice. This study was a prospective, single-arm, feasibility study conducted at two university-affiliated hospitals in South Korea. Small bowel evaluation was performed using a newly developed 3D capsule endoscope for patients with obscure gastrointestinal bleeding, suspected or established Crohn's disease, small bowel tumors, and abdominal pain of unknown origin. We assessed the technical limitations, performance, and safety of the new capsule endoscope. Thirty-one patients (20 men and 11 women; mean age: 44.5 years) were enrolled. There was no technical defect preventing adequate visualization of the small bowel. The overall completion rate was 77.4%, the detection rate was 64.5%, and there was no capsule retention. All capsule endoscopic procedures were completed uneventfully. In conclusion, newly developed 3D capsule endoscopy was safe and feasible, showing similar performance as conventional capsule endoscopy. Newly added features of 3D reconstruction and size measurement are expected to be useful in the characterization of subepithelial tumours. Since its development in 2000, capsule endoscopy has played major roles in the evaluation of small bowel disease 1. However, current capsule endoscopy has many limitations, and continuous research and development have been performed to overcome these limirations 2,3. One of the major drawbacks is the inability of capsule endoscopy to measure the accurate size of the lesion. In addition, due to its passive movement and uncontrolled air insufflation, characterization of excavated or polypoid lesions is difficult in some cases (e.g., differentiation of mass and mucosal bulges) 4. To solve these problems, the three-dimensional (3D) reconstruction of the capsule image has been attempted but has shown limited utility so far 4,5. A typical 3D-imaging system requires multiple independent cameras to reconstruct three-dimensional structures. However, due to the limited hardware resources pertaining to capsule size and battery capacity, there has been no hardware-enabled 3D reconstruction to date. Instead, software approaches (e.g., Shape-form-Shading, SfS) have been used to reconstruct 3D small bowel structures 6,7. Software approaches have the fundamental limitation of estimating accurate and robust 3D information without newly added image information. Even though this tool has shown some usefulness in the interpretation of capsule images, it has had limited clinical significance due to its inherent limitations 4,5. Recently, IntroMedic Company (Seoul, ...

Section: Discussionsupporting

confidence: 89%

3D reconstruction of small bowel lesions using stereo camera-based capsule endoscopy

Lim

et al. 2020

Sci Rep

“…VCE is a safe technique and accumulating data from large studies indicate that the incidence of intestinal retention is less than 2%. Certain conditions, such as intestinal tumours and Crohn's disease that limit passage in the small bowels may predispose capsule retention in the GI tract potentially causing bowel obstruction (9,10). The most common site of capsule retention is the small bowel, but other localizations, including oesophagus, stomach and airways have also been reported (12).…”

Section: Discussionmentioning

confidence: 99%

“…Beside the work-up of obscure gastrointestinal bleeding (OGIB) and in the evaluation of intestinal lesions related to non-steroidal anti-inflammatory drugs (NSAIDs) and celiac disease, VCE is particularly useful in the diagnosis and surveillance of Crohn's disease (3)(4)(5)(6)(7)(8). It is generally held that VCE is a safe method to examine the small bowel (9,10). Nonetheless, capsule retention is a feared complication with the potential to cause acute small bowel obstruction requiring emergency surgery (11).…”

Section: Introductionmentioning

confidence: 99%

Colonic obstruction caused by video capsule entrapment in a metal stent

Tóth¹,

Marthinsen²,

Bergström³

et al. 2017

Ann. Transl. Med.

Self Cite

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.

“…Retencija se definira kao prisutnost kapsule u crijevu 14 dana nakon ingestije s incidencijom od 1 do 2% pri suspektnom CB-u, dok kod dokazanog CB-a raste do 13%. 6 Znatno suženje lumena crijeva zbog tumora ili striktura povisuje rizik od retencije. Retinirana se endokapsula uklanja enteroskopijom, a nemogućnost izvlačenja odnosno nenalaženje endokapsule nalaže njezino kirurško uklanjanje.…”

Section: Raspravaunclassified

Non-Hodgkin’s lymphoma discovered by impacted endocapsule in a stenotic small intestine – a case report

Augustin

Haberle

Jelinčić

2019

SAŽETAK. Endokapsula, endoskopska metoda odobrena 2001. godine, upotrebljava se za evaluaciju sluznice i unutrašnjosti tankog crijeva. Posebno je važna pri patologiji tankog crijeva nedohvatljivoj dijagnostikom poput enteroskopije i ileokolonoskopije, koje su i dalje zlatni standard. Glavna komplikacija endokapsule jest njezina retencija, koja se javlja u stanjima što opstruiraju lumen crijeva poput upalnih bolesti crijeva, polipoznih sindroma i tumora crijeva. Prikazujemo 59-godišnju bolesnicu koja je zbog nespecifičnih simptoma i sumnje na upalnu bolest crijeva podvrgnuta metodi endokapsule što je zaostala u tankom crijevu i poslije eksplorirana invazivnom kirurškom tehnikom. Dijagnostička metoda poput magnetske enterografije izbjegla bi komplikaciju koju stvara endokapsula i dovela do ranijeg prepoznavanja teških bolesti što zahvaćaju tanko crijevo.