Asymptomatic bronchial aspiration of a video capsule

Aspiration is a rare complication of video-capsule endoscopy. We report a case of asymptomatic aspiration of the capsule in a 90-year-old man. The diagnosis was obtained by the images taken by the capsule. Rigid bronchoscopy was used to remove the capsule. Recommendations to prevent this complication are: (1) Patients with swallowing disorders should have the capsule placed into the duodenum at the time of upper endoscopy. The capsule should never be placed in the stomach because of prolonged emptying times following endoscopy and IV sedation. (2) If a patient appears to have difficulty swallowing the capsule after two or three attempts, the capsule should be placed endoscopically. (3) When real-time capsule location is more readily available, the abdomen can be scanned after the initial ingestion to be sure that the capsule reached the stomach.