Endoscopic capsule retention: a complication with an underappreciated cause

Abstract

The patient we are describing underwent laparoscopic appendicectomy 18 months prior to the current presentation. During that operation, the appendix was divided between two polydioxanone Endoloop ligatures and an Endo Catch was used to retrieve the specimen. A preperitoneal abscess above the bladder suggests that the appendicolith must have gained access to the preperitoneal space through the suprapubic port and we hypothesize that the fecolith had entered the preperitoneal space when the port was removed.There is limited literature on the optimal method of treating appendicolith-related abscesses. In general, the management of these retained appendicoliths requires drainage of the abscess and extraction of the appendicolith. 1,4 However, CT-guided drainage or percutaneous removal using a basket retrieval device has been reported with success. 2,8 In conclusion, the possibility of retained appendicolith should be considered in patients presenting with recurrent intraabdominal sepsis and a history of appendicectomy. A number of techniques have been proposed to minimize the risk of appendicolith spillage. These include dividing the appendix between double ligatures 9 and gentle manipulation when handling an acutely inflamed appendix. In the event of spillage, the appendicolith ought to be retrieved, as failure to do so may lead to subsequent complications.

Platelet–lymphocyte ratio as a predictor of lymph node metastasis in small bowel cancer

“…Common diagnostic methods such as Bultrasound and CT scans have limited sensitivity for detecting early small intestine tumors. Furthermore, small intestine capsule endoscopy can lead to intestinal retention, while double-balloon endoscopy carries a risk of serious complications like acute pancreatitis and intestinal perforation [10] . Consequently, small bowel cancer often goes undetected, with the probability of a diagnosis-to-metastasis reaching as high as 32% to 33% [11] .…”