Can we predict spontaneous capsule passage after retention? A nationwide study to evaluate the incidence and clinical outcomes of capsule retention

Cheon, Jae Hee; Kim, Yunhan; Lee, I. S.; Chang, David K.; Ryu, Ji Kon; Lee, K. J.; Moon, Jeong Seok; Park, C. H.; Kim, J. O.; Shim, Ki Nam; Choi, Chang Hwan; Cheung, Dae Young; Jang, Byung Ik; Seo, Grace; Hu, Chun; Choi, Myung‐Gyu

doi:10.1055/s-2007-966978

Cited by 115 publications

(104 citation statements)

References 17 publications

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“…The studies have suggested that asymptomatic capsule retention can undergo expectant, medical and endoscopic management or even surgical intervention [14][15][16][17] . Meanwhile, the longest duration of retention is 2.5 years reported by ICCE without reporting the sequelae associated with long term retention of capsule [6] .…”

Section: Discussionmentioning

confidence: 99%

“…But the patient should not undergo magnetic resonance imaging [17] . Authors have advocated that surgical intervention not only allows removal of the capsule but also can remove the offending pathology causing capsule retention [9,[14][15][16] . In a systematic review of 184 capsule retentions from Liao et al [9] , retained capsules were excreted spontaneously or by pharmaceutical manipulation in 15%, endoscopically in 12% and the majority 58.7% were removed surgically.…”

Section: Discussionmentioning

confidence: 99%

“…Rest 10 (31.3%) patients ultimately underwent surgical intervention to retrieve the capsule [15] . Medical management usually consists of use of anti-inflammatory agents and colonoscopy preparation fluids or enemas [10,18] .…”

mentioning

confidence: 99%

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Longest duration of retention of video capsule: A case report and literature review

Bhattarai

Bansal²,

Khan³

2013

WJGE

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Video capsule endoscopy (VCE) is a safe innovative tool for investigating obscure gastrointestinal bleeding, Crohn's disease and other small bowel pathologies. The capsule is usually excreted with faeces within 24-48 h. Retention of capsule rarely occurs, and it usually depends on the indication of VCE. The longest reported case of capsule retention in the literature is 2.5 years. Surgical approach is considered effective to retrieve the retained capsule. We present a case of asymptomatic retention of capsule for four and half years in a 49-yearold man who underwent VCE to explore the cause of obscure gastrointestinal bleeding. It was successfully retrieved endoscopically. We will also briefly review the literature regarding the causes, different presentations and management of capsule retention. Core tip: We present the longest case of asymptomatic video capsule retention in the literature. With our case we would like to highlight that asymptomatic video capsule retention is not an indication for surgical retrieval. Capsule can retain for long time without harm. Surgical retrieval should be reserved for those patients in whom the expectant management, medical management and endoscopic therapy fails or in patients who are symptomatic with intestinal obstruction or perforation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Longest duration of retention of video capsule: A case report and literature review

Bhattarai

Bansal²,

Khan³

2013

WJGE

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“…In fact, it is being currently considered as a first line diagnostic tool for small bowel examination. However, adverse events (AEs) during CE procedures such as capsule retention or aspiration can occur, ranging from 0% in healthy volunteers to 21% in those patients with suspected small bowel obstruction (2,(5)(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population

Fernández-Urién¹,

Carretero²,

González³

et al. 2015

Rev Esp Enferm Dig

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Introduction: Capsule endoscopy (CE) has become a first-line tool for small bowel (SB) examination. However, adverse events (AEs), such as CE retention or aspiration, may occur. The aims of this study were to evaluate incidence, clinical outcomes and therapeutic approaches of CE-related AEs in the largest series published to date.Methods: Data from 5428 procedures performed at 12 institutions between August 2001 and January 2012 were retrospectively analyzed. Baseline patient characteristics; procedure; type, localization and symptoms before/after AEs; previous patency tests performed; therapeutic management and patient´s outcome were recorded.Results: The overall incidence of CE-related AEs was 1.9%: 2.0% for SB, 0.9% for esophageal and 0.5% for colon CE. The incidence of capsule retention was significantly higher than capsule aspiration (1.87% vs. 0.003%; p < 0.05), in patients suffering from inflammatory bowel disease (IBD) than in obscure GI bleeding (OGIB) (3.3% vs. 1.5%; p < 0.05) and in patients with the combination of nausea/vomiting, abdominal pain and distension. The SB was the most frequent localization of retention (88.2%). The use of patency tests -except for Patency © capsule-before CE was not a good predictor for AEs. Most of the patients with AEs developed no or mild symptoms (97%) and were managed by non-surgical methods (64.4%).Conclusions: CE-related AEs are uncommon and difficult to predict by imagiological examinations. SB retention, that is usually asymptomatic, is the most frequent AE. In absence of symptoms, non-surgical management of CE-related AEs is recommended.

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“…It delivers ionising radiation and is suboptimal for the assessment of extraintestinal involvement and complications. WCE on the other hand allows for excellent visualization of the SB mucosa, but its specificity is lower than other methods [6] , it does not clearly localise the lesions, histology cannot be taken, and there is a small but definite capsule retention rate contraindicating its use in SB strictures [7] . CTE has been well described [8] , has good sensitivity (71%-95%) and impressive specificity (90%-98%) and is superior to conventional enteroclysis [9] .…”

Section: Introductionmentioning

confidence: 99%

Correlation of MRI-determined small bowel Crohn’s disease categories with medical response and surgical pathology

Lawrance¹,

Welman²,

Shipman³

et al. 2009

WJG

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AIM:To determine whether magnetic resonance imaging (MRI) can be used to categorize small bowel Crohn's disease (SB CD) into groups that correlate with response to medical therapy and surgical pathology. METHODS:Data was collected from all patients with MRI evidence of SB CD without significant colonic disease over a 32-mo period. Two radiologists, blinded to clinical findings, evaluated each MRI and grouped them based on bowel wall thickness and wall enhancement. These categories were: (1) "fibrosis", (2) "mild segmental hyper-enhancement and mild wall thickening", (3) "mild segmental hyper-enhancement and marked wall thickening", (4) "marked segmental transmural hyper-enhancement". Patient response to additional medical therapy post-MRI was prospectively determined at 8-wk. Non-responders underwent endoscopy and were offered therapeutic endoscopy or surgery. Surgical pathology was assessed against the MRI category. RESULTS:Fifty-five patients were included. Females and category "2" patients were more likely, and patients with luminal narrowing and hold-up less likely, to respond to medical therapy (P < 0.05). Seventeen patients underwent surgery. The surgical pathological findings of fibrosis and the severity of inflammation correlated with the MRI category in all cases. CONCLUSION:Our findings suggest that SB CD can be grouped by the MRI findings and that these groups are associated with patients more likely to respond to continued medical therapy. The MRI categories also correlated with the presence and level of intestinal inflammation and fibrosis on surgical pathology, and may be of prognostic use in the management of CD patients.

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Can we predict spontaneous capsule passage after retention? A nationwide study to evaluate the incidence and clinical outcomes of capsule retention

Cited by 115 publications

References 17 publications

Longest duration of retention of video capsule: A case report and literature review

Longest duration of retention of video capsule: A case report and literature review

Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population

Correlation of MRI-determined small bowel Crohn’s disease categories with medical response and surgical pathology

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