Colon Cancer Detection by ‘Rendezvous Colonoscopy’: Successful Removal of Stuck Colon Capsule by Conventional Colonoscopy

Abstract

Although capsule retention is a known complication of small bowel capsule endoscopy, initial studies with colon capsule endoscopy (CCE) have not reported any capsule retention or sticking neither in the small bowel nor in the colon. We report a complication of CCE when the stuck colon capsule was passed through the malignant colon stricture and removed by the aid of a flexible colonoscope. During CCE in a 76-year-old iron deficiency anemia patient the real-time viewing system indicated the colon capsule to be stuck in a malignant ascending colon stricture for more than two hours. With the aim to avoid complete capsule retention, immediate colonoscopy was performed. The stuck capsule was caught by a polypectomy snare, passed through the tumor stricture and finally removed from the large bowel. The current case describes the usefulness of the real-time viewing system. Similar situations may occur during the forthcoming spread of CCE and the present case is an example of how to manage the potentially risky stuck colon capsule condition.

Small intestinal diverticulum with bleeding

“…The whole digestive tract barium meal cannot provide the entire view of the small intestine or obtain integrative imaging of the small intestine; as it sometimes can even induce intestinal obstruction, it can also be excluded from examination of diverticulum. Although it was reported that wireless capsule endoscopy is a useful diagnostic tool for diagnosing Meckel diverticulum, [ 23 , 24 ] the camera can sometimes become stuck in the intestine [ 25 , 26 ] and cause dangerous conditions [ 27 ] ; thus, wireless capsule endoscopy might not be the first choice for examining small intestinal diverticulum. [ 28 ] Compared with capsule endoscopy, double-balloon enteroscopy is reported to be a safer and more effective method; in addition, as it can be used to examine small intestinal diverticulum from both oral and anal directions and the small bowel completely, it can determine the specific location of the small intestinal lesions.…”

A Fluorescence-Based Wireless Capsule Endoscopy System for Detecting Colorectal Cancer

“…Therefore, the lifetime is enough to cover most patient's GI transit time [43,44]. However, an increased battery life may be useful for patients who need a longer GI transit time (capsule retention or other chronic disease) [45,46].…”

Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

“…Available studies with CCE, despite the larger capsule size, have not reported any capsule retention or sticking either in the small bowel or in the colon [7 -20]. Of note, a case of CCE where a stuck colonic capsule was passed through a malignant colonic stricture and removed with the aid of flexible colonoscopy has recently been reported [47]. Removal of colonic capsule retained in the small bowel may require surgery, although removal by device-assisted enteroscopy may be an option [45].…”