Capsule retention: prevention, diagnosis and management
1Gastroenterology Unit, Ospedale Valduce, Como, Italy.
Annals of Translational Medicine
|June 2, 2017
Summary
Capsule retention, where a capsule endoscopy device remains in the digestive tract for over two weeks, requires prompt diagnosis and management. Retrieval is recommended for long-term asymptomatic cases to prevent complications.
Area of Science:
- Gastroenterology
- Medical Imaging
- Endoscopy
Background:
- Capsule retention (CR) affects approximately 2% of patients undergoing small bowel capsule endoscopy (CE).
- Prompt diagnosis of CR is crucial due to its clinical implications.
- CR should be suspected in asymptomatic patients without capsule excretion within 15 days or those with obstructive symptoms.
Purpose of the Study:
- To define capsule retention and outline diagnostic and management strategies.
- To review the clinical implications and potential complications of CR.
- To discuss methods for preventing CR.
Main Methods:
- Review of diagnostic criteria for CR.
- Discussion of imaging modalities for CR confirmation (X-ray, CT).
- Evaluation of management options including watchful monitoring, medical therapy, and retrieval (endoscopic or surgical).
Main Results:
- Abdominal plain X-ray is the primary diagnostic tool for CR.
- Watchful monitoring is often suggested for asymptomatic CR.
- Endoscopic retrieval is preferred, with surgery as an alternative for complicated or unsuccessful retrieval.
- Medical therapy may aid excretion in inflammatory bowel disease (IBD) patients.
Conclusions:
- Long-term CR, even if asymptomatic, warrants retrieval due to risks of fragmentation, obstruction, and perforation.
- Preventive measures like Patency Capsule (PC) or imaging techniques exist but lack comparative studies.
- Effective diagnosis and management are essential to mitigate CR complications.
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