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The longest duration of retention of a video capsule

Chris Harrington1, Colin Rodgers2

  • 1Department of Medicine, Northern Health and Social Care Trust, Antrim, UK.

BMJ Case Reports
|July 10, 2014
PubMed

Insights

A 15-year-old boy with Crohn's disease experienced capsule retention for nearly 7 years. This case highlights the long-term implications of undiagnosed small bowel inflammation.

Area of Science:

  • Gastroenterology
  • Pediatric Medicine
  • Diagnostic Imaging

Background:

  • Investigated iron deficiency anemia in an underweight adolescent.
  • Suspected subclinical small bowel Crohn's disease based on elevated blood counts and imaging.
  • Utilized video capsule endoscopy (VCE) for diagnosis.

Observation:

  • VCE revealed inflammation and ulcers in the terminal ileum, confirming Crohn's disease.
  • The capsule was retained by March 2008, despite steroid treatment.
  • Imaging over several years showed the capsule's migration within inflamed small bowel loops.

Findings:

  • The patient remained asymptomatic despite long-term capsule retention.
  • Computed tomography (CT) identified the capsule within a mass of matted small bowel loops.
  • Capsule retention persisted asymptomatically for 6 years and 10 months.

Implications:

  • Demonstrates a rare complication of capsule endoscopy in pediatric Crohn's disease.
  • Highlights the challenges in managing retained capsules in complex small bowel pathology.
  • Underscores the importance of long-term monitoring in patients with inflammatory bowel disease.

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