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What we have learned from 5 cases of permanent capsule retention
Matthew M Baichi1, Razi M Arifuddin, Parvez S Mantry
1Digestive and Liver Diseases Unit, University of Rochester Medical Center, Rochester, New York 14642, USA.
Background:
Capsule endoscopy allows the direct visualization of the entire small bowel. There is limited data on the clinical significance of permanent capsule retention.
Objective:
Our purpose was to document the frequency, findings, risk factors, management, and outcomes of permanent capsule retention.
Design:
Retrospective, case series.
Setting:
Single tertiary referral center, outpatient.
Results:
Permanent capsule retention occurred in 2% of our cases (5/245). The following pathologies caused insufficient capsule passage: adenocarcinoma in a patient with hereditary nonpolyposis colorectal cancer (1), idiopathic stenosis (1), stricturing Crohn's disease (2), and adhesions (1). Capsule retention lead to a symptomatic small-bowel obstruction in only 1 of these cases (0.4%). As a consequence, 2 cases had successful endoscopic retrieval; 3 cases required surgical intervention. Four of 5 patients had a clear clinical benefit resulting from the capsule findings or the secondary procedure.
Conclusions:
Permanent capsule retention is rare. Even though this event may lead to the necessity of an endoscopic or surgical intervention, a clear benefit for the patient in respect to the underlying disease resulted in 4 of 5 patients.
Insights
Permanent capsule retention during capsule endoscopy is rare, occurring in 2% of cases. Despite potential complications, it often leads to significant clinical benefit for patients with underlying small bowel diseases.
Area of Science:
- Gastroenterology
- Medical Devices
- Diagnostic Imaging
Background:
- Capsule endoscopy offers direct visualization of the small bowel.
- Data on permanent capsule retention is limited.
- Understanding retention significance is crucial for patient management.
Observation:
- A retrospective case series was conducted at a single tertiary referral center.
- The study analyzed 245 outpatient capsule endoscopy procedures.
- Focus was on documenting permanent capsule retention events.
Findings:
- Permanent capsule retention occurred in 2% (5/245) of patients.
- Causes included adenocarcinoma, idiopathic stenosis, Crohn's disease, and adhesions.
- Only 0.4% experienced symptomatic small-bowel obstruction; 4/5 patients benefited clinically.
Implications:
- Permanent capsule retention is an infrequent complication of capsule endoscopy.
- Interventions like endoscopic retrieval or surgery may be necessary.
- Retention can lead to diagnosis and treatment, offering clear patient benefit.
