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Dig Dis Sci. 2019 May 11. doi: 10.1007/s10620-019-05659-7. [Epub ahead of print]

Outcomes and Management Strategies for Capsule Retention: A Korean Capsule Endoscopy Nationwide Database Registry Study.

Author information

1
Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.
2
Department of Internal Medicine, Dongguk University College of Medicine, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang, Republic of Korea. drlimyj@gmail.com.
3
Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea.
4
Department of Internal Medicine, Hallym University College of Medicine, Hwasung, Republic of Korea.
5
Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
6
Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
7
Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.
8
Department of Internal Medicine, Inje University College of Medicine, Busan, Republic of Korea.
9
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
10
Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea.
11
Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea.
12
Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
13
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea.

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. Three-fourths of the patients with CR were managed with endoscopic or surgical intervention, which was required particularly in patients with abdominal symptoms after CR.

KEYWORDS:

Capsule endoscopy; Retention; Small bowel

PMID:
31076988
DOI:
10.1007/s10620-019-05659-7

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