What we have learned from 5 cases of permanent capsule retention

Abstract

Capsule endoscopy allows the direct visualization of the entire small bowel. There is limited data on the clinical significance of permanent capsule retention. Our purpose was to document the frequency, findings, risk factors, management, and outcomes of permanent capsule retention. Retrospective, case series. Single tertiary referral center, outpatient. Permanent capsule retention occurred in 2% of our cases (5/245). The following pathologies caused insufficient capsule passage: adenocarcinoma in a patient with hereditary nonpolyposis colorectal cancer (1), idiopathic stenosis (1), stricturing Crohn's disease (2), and adhesions (1). Capsule retention lead to a symptomatic small-bowel obstruction in only 1 of these cases (0.4%). As a consequence, 2 cases had successful endoscopic retrieval; 3 cases required surgical intervention. Four of 5 patients had a clear clinical benefit resulting from the capsule findings or the secondary procedure. Permanent capsule retention is rare. Even though this event may lead to the necessity of an endoscopic or surgical intervention, a clear benefit for the patient in respect to the underlying disease resulted in 4 of 5 patients.