Outcomes and Management Strategies for Capsule Retention: A Korean Capsule Endoscopy Nationwide Database Registry Study
- Author(s)
- Hyun Seok Lee; Yun Jeong Lim; Kyeong Ok Kim; Hyun Joo Jang; Jaeyoung Chun; Seong Ran Jeon; Yunho Jung; Ji Hyun Kim; Jae Jun Park; Sun‑Jin Boo; Sun Hyung Kang; Seung‑Joo Nam; Yoo Jin Lee
- Keimyung Author(s)
- Lee, Yoo Jin
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- Digestive Diseases and Sciences
- Issued Date
- 2019
- Volume
- 64
- Issue
- 11
- Keyword
- Capsule endoscopy; Small bowel; Retention
- Abstract
- Background
The most concerning complication of capsule endoscopy (CE) is capsule retention (CR) in the gastrointestinal (GI) tract; however, the clinical outcomes and management of patients with CR are still uncertain. Aims This study aimed to investigate the clinical outcomes and management of CR.
Methods
The outcomes of CR in multiple centers between October 2002 and June 2018 were retrospectively reviewed. Data on CE indication, findings, and management details were analyzed.
Results
A total of 2705 consecutive small-bowel CE procedures were performed. CR was detected in 20 cases (0.7%). The most common site of CR was the small bowel (19 cases), followed by the esophagus (one case). In patients who underwent CE, CR was detected in nine (0.6%) of 1397 patients with obscure GI bleeding. Further, CR occurred in 11 (6.5%) of 169 patients with Crohn’s disease based on the final diagnoses after CE. Capsule retrieval was safely performed surgically in nine cases and endoscopically in six cases. The retained capsules dislodged after steroid treatment in two cases, whereas three cases of CR resolved without any intervention. In multivariate analysis, the development of abdominal symptoms after CR was a significant predictive factor for requiring endoscopic or surgical interventions for capsule extraction.
Conclusions
This large multicenter study shows that CR is a rare complication with favorable clinical outcomes. Threefourths of the patients with CR were managed with endoscopic or surgical intervention, which was required particularly in patients with abdominal symptoms after CR.
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