Can we predict spontaneous capsule passage after retention? A nationwide study to evaluate the incidence and clinical outcomes of capsule retention.
OBJECTIVE
Although capsule endoscopy has become a central diagnostic tool for small-bowel evaluation, retention of a capsule remains a major concern. This study attempted to investigate the incidence and clinical outcomes of capsule retention, and to determine the factors predictive of spontaneous capsule passage after retention.


METHODS
Through a nationwide multicenter survey, we retrospectively reviewed the records of 1291 patients who had a capsule endoscopy between February 2002 and July 2006 in Korea. Clinical and procedural characteristics and postprocedural outcomes were analyzed for the cases with capsule retention.


RESULTS
Capsule retention occurred in 2.5 % of total cases (32/1291). The major diseases accompanying capsule retention were Crohn's disease, malignant tumors, and tuberculous enterocolitis, in decreasing order. In 11 of the 32 patients (34.4 %), early surgical or endoscopic interventions were instituted for diagnosis or treatment of diseases before retention symptoms developed. The remaining 21 (65.6 %) patients initially received medical treatments. Of these, 10 (31.3 %) ultimately underwent surgical intervention due to the development of symptoms of intestinal obstruction or medical treatment failure. The other 11 (34.4 %) eventually passed the capsule. The presence of a larger lumen diameter (greater than two-thirds of the capsule diameter) at the stricture site was associated with spontaneous passage.


CONCLUSIONS
Our large-scale study suggests that retention occurs infrequently during capsule endoscopy. Moreover, a retained capsule might indicate the best intervention for the offending pathology, or it may spontaneously pass in the long run, particularly in patients with less small bowel stricture.
Cheon
J H
JH
Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Kim
Y-S
YS
Lee
I-S
IS
Chang
D K
DK
Ryu
J-K
JK
Lee
K J
KJ
Moon
J-S
JS
Park
C H
CH
Kim
J-O
JO
Shim
K-N
KN
Choi
C H
CH
Cheung
D Y
DY
Jang
B I
BI
Seo
G-S
GS
Chun
H-J
HJ
Choi
M-G
MG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053705:Capsule Endoscopes / Q000009:adverse effects*; D053704:Capsule Endoscopy / Q000009:adverse effects* / Q000379:methods; D004868:Equipment Failure; D005260:Female; D005547:Foreign Bodies / Q000453:epidemiology* / Q000209:etiology; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007410:Intestinal Diseases / Q000175:diagnosis*; D007415:Intestinal Obstruction / Q000453:epidemiology* / Q000209:etiology; D007421:Intestine, Small; D007723:Korea; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment