Capsule retention in Crohn's disease requiring surgical management: two case reports

Capsule endoscopy is an established diagnostic modality for small bowel evaluation, particularly in Crohn's disease. Capsule retention remains its most significant complication, especially in patients with stricturing disease. We report two cases of asymptomatic capsule retention in patients with established Crohn's disease. In both cases, cross-sectional imaging failed to predict clinically significant stenosis. Capsule retention was confirmed radiologically after 2 weeks. Corticosteroid therapy did not result in capsule passage, and both patients ultimately required surgical intervention. Surgical management allowed capsule retrieval and definitive treatment of underlying strictures through bowel resection and stricturoplasty. These cases highlight the importance of appropriate pre-procedural risk stratification and multidisciplinary management. Routine use of cross-sectional imaging and, when available, patency capsule testing is strongly recommended in patients at risk of small bowel stenosis.