Ileus related to wireless capsule retention in suspected Crohn’s disease: emergency surgery obviated by early pharmacological treatment

Abstract

A previously healthy 21-year-old woman without a history suggesting stenosis and normal ileocolonoscopic findings underwent wireless capsule endoscopy (PillCam SB 11 × 26 mm; Given Imaging, Yoqneam, Israel) for suspected Crohn’s disease of the small bowel. Approximately 16 hours after capsule intake, she developed small-bowel ileus ([Fig. 1]). The capsule recording showed skip lesions of inflamed small bowel with ulcerations, swelling, pseudopolyps, and stenosis ([Fig. 2]). After 6.5 hours, capsule progression was halted by a strictured small-bowel segment with severely active disease ([Fig. 3]). A diagnosis of severe stenosing Crohn’s disease of the small bowel with subsequent capsule retention leading to obstruction of the small bowel was made.