Capsule endoscopic detection of bleeding Meckel’s diverticulum, with capsule retention in the diverticulum

Tanaka, Yuichi; Motomura, Yasuaki; Akahoshi, Kazuaki; Nakama, Naotaka; Osoegawa, Takashi; Kashiwabara, Yumi; Chaen, T.; Higuchi, Naomi; Kubokawa, Masaru; Nishida, Koujiro; Yukaya, Takafumi; Oya, Masafumi; Nakamura, K.

doi:10.1055/s-0030-1255696

Cited by 17 publications

(12 citation statements)

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“…In false-negative cases, mesenteric arteriography or DBE can help in achieving a correct diagnosis. Zheng and co-workers reported 28 children with OGIB who had negative Meckel’s scan and, in 10 patients, Meckel’s diverticulum was diagnosed by DBE [63]; CE is another diagnostic modality, but there is risk of capsule retention [65, 66]. …”

Section: Aetiologymentioning

confidence: 99%

Small bowel bleeding: a comprehensive review

Gunjan

Sharma

Bhasin

2014

Gastroenterology Report

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The small intestine is an uncommon site of gastro-intestinal (GI) bleeding; however it is the commonest cause of obscure GI bleeding. It may require multiple blood transfusions, diagnostic procedures and repeated hospitalizations. Angiodysplasia is the commonest cause of obscure GI bleeding, particularly in the elderly. Inflammatory lesions and tumours are the usual causes of small intestinal bleeding in younger patients. Capsule endoscopy and deep enteroscopy have improved our ability to investigate small bowel bleeds. Deep enteroscopy has also an added advantage of therapeutic potential. Computed tomography is helpful in identifying extra-intestinal lesions. In cases of difficult diagnosis, surgery and intra-operative enteroscopy can help with diagnosis and management. The treatment is dependent upon the aetiology of the bleed. An overt bleed requires aggressive resuscitation and immediate localisation of the lesion for institution of appropriate therapy. Small bowel bleeding can be managed by conservative, radiological, pharmacological, endoscopic and surgical methods, depending upon indications, expertise and availability. Some patients, especially those with multiple vascular lesions, can re-bleed even after appropriate treatment and pose difficult challenge to the treating physician.

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Section: Aetiologymentioning

confidence: 99%

Small bowel bleeding: a comprehensive review

Gunjan

Sharma

Bhasin

2014

Gastroenterology Report

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“…Since most of CE-related AEs have been published as case reports or case-series (9)(10)(11)(12)(13), there is a lack of consensus on this topic and many questions remain open. A better knowledge of CE-related AEs could have a positive influence in patients´ outcome.…”

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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“…In the present case, the capsule fell into the diverticulum with a narrow orifice, through which the capsule could not pass spontaneously. To the best of our knowledge, this is the longest duration of capsule retention in a Meckel's diverticulum retrieved by surgery . As is reported, retention may occur in situations that are associated with potential small bowel obstruction or strictures.…”

mentioning

confidence: 53%

“…To the best of our knowledge, this is the longest duration of capsule retention in a Meckel's diverticulum retrieved by surgery. [2][3][4] As is reported, retention may occur in situations that are associated with potential small bowel obstruction or strictures. We suggest that a thorough history, combined with necessary adjunctive examinations such as small bowel series, CT enteroclysis and patency capsule might help to avoid capsule retention.…”

Section: Letters Techniques and Imagesmentioning

confidence: 82%