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Small bowel perforation following capsule endoscopy: a case report.
J S Palmer1, K Marenah, F El Madani
1West Middlesex University Hospital, London, UK. jonpalmer@doctors.net.uk
Annals of the Royal College of Surgeons of England
|September 21, 2011
Summary
Capsule endoscopy rarely causes small bowel perforation. This case highlights a perforation in Crohn's disease despite negative preoperative stricture findings, emphasizing diagnostic challenges.
Area of Science:
- Gastroenterology
- Medical Devices
- Surgical Complications
Background:
- Capsule endoscopy (CE) is a valuable tool for visualizing the small intestine.
- Small bowel perforation is a rare but serious complication of CE.
- Crohn's disease poses unique challenges due to potential bowel strictures.
Observation:
- A patient with Crohn's disease developed small bowel perforation after undergoing CE.
- Preoperative investigations, including imaging, did not identify any bowel strictures.
- The perforation occurred in the absence of pre-existing, detectable obstructive lesions.
Findings:
- CE can induce small bowel perforation even when strictures are not evident preoperatively.
- The underlying Crohn's disease may have contributed to the perforation risk.
- Diagnostic limitations in identifying subtle or dynamic strictures can be a factor.
Implications:
- Clinicians must maintain a high index of suspicion for perforation in CE patients, especially those with inflammatory bowel disease.
- Further research may be needed to refine preoperative risk assessment for CE in Crohn's disease.
- This case underscores the importance of prompt diagnosis and management of CE-induced perforations.
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