Video capsule retention in a Zenker diverticulum

Area of Science:

• Gastroenterology
• Medical Devices
• Surgical Procedures

Background:

• Video capsule endoscopy (VCE) is a minimally invasive diagnostic tool for evaluating the gastrointestinal tract.
• Zenker diverticulum is a pharyngeal outpouching that can cause dysphagia and other symptoms.
• Accidental lodging of VCE in upper aerodigestive tract structures is a rare complication.

Observation:

• An unchanging image on the real-time viewer, dissimilar to esophageal or gastric mucosa, indicated the capsule was not in its expected location.
• The patient reported cervical discomfort, prompting suspicion of capsule retention in the pharynx.
• The video capsule endoscope was lodged within a Zenker diverticulum.

Findings:

• The lodged video capsule endoscope was successfully retrieved endoscopically.
• Repositioning the capsule using a hood-assisted endoscope allowed for successful completion of the examination.
• This case highlights a rare complication of VCE in patients with Zenker diverticulum.

Implications:

• This case underscores the importance of considering upper aerodigestive tract pathology in VCE studies with atypical imaging or symptoms.
• Endoscopic retrieval and repositioning techniques are crucial for managing VCE impaction.
• Awareness of this complication can guide pre-procedural patient selection and management strategies for VCE.