Colonic obstruction caused by video capsule entrapment in a metal stent

Abstract

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.

Video capsule endoscopy in pediatric patients with Crohn’s disease: a single-center experience of 180 procedures

“… 7 , 20 , 21 , 27 This case of capsule retention was special in the sense that the capsule was retained in a metallic stent. 28 Thus, previous stenting in the GI tract should be taken into consideration before performing VCE. Notably, we did not observe any capsule retention in the SB, which is in line with a previous prospective study of patients with inflammatory bowel disease.…”

Colon capsule retention in a patient with large bowel stenosis due to diverticulosis – a case report

“… 3 Most reported cases show retention in the small bowel, and only few cases of colonic CR have been reported. 4 , 5 …”

“…3 Most reported cases show retention in the small bowel, and only few cases of colonic CR have been reported. 4,5 We present a case of CR in a patient with an asymptomatic and undiagnosed stenosis in the colon and the subsequent endoscopic and surgical treatment initiated by the incomplete CE.…”

Endoscopic video capsule retention, a new medical-surgical disease: case series

“…Endoscopic video capsule (EVC) has become the most useful tool for the study of the small bowel, allowing its direct visualization with better tolerance [1][2][3][4][5] . Video capsule endoscopy (VCE) is classically used in the study of occult gastrointestinal (GI) bleeding, but in the last decade its usefulness has been demonstrated in the diagnosis and followup of other type of diseases, such as Crohn's disease, when small bowel tumors are suspected, and in the diagnosis and follow-up of hereditary polyposis syndrome 2,[6][7][8][9] .…”