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

Abstract

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.

Colon capsule endoscopy for inflammatory bowel disease

“…For SBCE, CD was an independent risk factor for capsule retention, and capsule retention rate in confirmed CD patients was higher than suspected CD patients (0–13.2% vs. 0–5.4%) . In a large retrospective study of 5 428 CE procedures, the overall incidence of CE‐related adverse events was higher for SBCE (2.0%) than for CCE (0.5%), and the capsule retention rate in patients suffering from IBD was higher than in those with other indications (3.3% vs 1.5%, P < 0.05) . In studies that used CCE for IBD (Tables and ), the rate of capsule retention was 2.3%.…”

Capsule retention: prevention, diagnosis and management

“…According to the abovementioned definition, in both large population-based studies and in a recently published metaanalysis of 67 studies, the overall CR rate is approximately 2% (5)(6)(7)(8)(9)(10)(11)(12)(13). Recently, Iijima et al (14) evaluated the time-trend of CR rate, by comparing US, EU and Japan pre-marketing and post-marketing data.…”

Small-bowel capsule endoscopy with panoramic view: results of the first multicenter, observational study (with videos)

“…As reported in previous studies on front-viewing capsules [1,21], we focused our attention on capsule aspiration, at time of ingestion, and/or on capsule retention. The latter was defined as the persistence of the capsule within the patient's intestinal tract, demonstrated by means of an abdominal radiograph, 15 days after capsule ingestion.…”