A Case of Wireless Small Bowel Capsule Presenting as Pulmonary Foreign Body

Abstract

Purpose: Wireless small bowel capsule endoscopy allows endoscopic evaluation of the entire small bowel. It is a very helpful test to diagnose small bowel diseases. We are presenting a case of small bowel capsule endoscopy where the patient aspirated the wireless capsule due to partial duodenal obstruction and later developed shortness of breath and was found to have a small bowel capsule lodged in the right lower lobe bronchus of the lung. A 67 year old male patient was being evaluated for abdominal pain and anemia. Upper endoscopy revealed hiatal hernia and gastritis. Colonoscopy showed diverticulosis, sigmoid polyp, and internal hemorrhoids. A wireless small bowel capsule endoscopy was performed to evaluate the small bowel and to look for sources of blood loss like ileal Crohn's, small bowel AVMs, and small bowel tumors. Capsule endoscopy recording showed duodenal AVMS and narrowing of the lower part of the duodenum, jejunum and ileum were not visualized. The patient was called and he denied any nausea, vomiting or abdominal pain. A few days later he complained of mild shortness of breath. A chest x-ray was ordered which showed the capsule endoscopy pill lodged in the right lower lobe bronchus. An emergency bronchoscopy was done and the wireless capsule was removed from the right lower lobe bronchus. Wireless small bowel capsule endoscopy can be associated with pulmonary aspiration. Our patient was asymptomatic initially but later developed shortness of breath. In patients with partial or incomplete recording with small bowel capsule endoscopy system an effort should be made to locate the position of capsule in the body by radiological imaging.Figure: No Caption available.Figure: No Caption available.