title: Unawareness of a Prolonged Retained Capsule Endoscopy: The Importance of Careful Follow-Up and Cooperation between Medical Institutions.
abstract: A 50-year-old man with anemia was referred to our hospital to undergo capsule endoscopy (CE), which revealed small intestinal ulcers. After 5 months of CE, he returned because of recurrent anemia without abdominal symptoms. Abdominal X-ray and computed tomography showed capsule retention in the small intestine at the pelvic cavity. The capsule remained at the same place for 7 days. We performed capsule retrieval by laparoscopy-assisted surgery with resection of the involved small intestine, including an ileal stricture. Resected specimen showed double ulcers with different morphologies, an ulcer scar with stricture, and a wide ulcer at the proximal side of the others. Each ulcer had different histopathological findings such as the degree of fibrosis and monocyte infiltration. These differences led us to consider that the proximal ulcer may have been secondarily induced by capsule retention. Our experience indicated that careful follow-up and the cooperation between medical institutions after CE examination should be undertaken for patients with incomplete examination, unknown excretion of the capsule, and/or ulcerative lesions despite the lack of abdominal symptoms. Additionally, a retained CE remaining over long periods and at the same place in the small intestine may lead to secondary ulceration.
authors.affiliation: Department of Surgery, Wakaba Hospital, 28-13 Minami-Chuo, Tsu, Mie 514-0832, Japan ; Department of Gastrointestinal and Pediatric Surgery, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Saigusa
authors.affiliation: Department of Surgery, Wakaba Hospital, 28-13 Minami-Chuo, Tsu, Mie 514-0832, Japan ; Department of Gastrointestinal and Pediatric Surgery, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ohi
authors.affiliation: Department of Surgery, Wakaba Hospital, 28-13 Minami-Chuo, Tsu, Mie 514-0832, Japan ; Department of Gastrointestinal and Pediatric Surgery, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Imaoka
authors.affiliation: Department of Surgery, Wakaba Hospital, 28-13 Minami-Chuo, Tsu, Mie 514-0832, Japan ; Department of Gastrointestinal and Pediatric Surgery, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Tadanobu
authors.initials: T
authors.lastname: Shimura
authors.affiliation: Department of Surgery, Wakaba Hospital, 28-13 Minami-Chuo, Tsu, Mie 514-0832, Japan ; Department of Gastrointestinal and Pediatric Surgery, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Uratani
authors.affiliation: Department of Surgery, Wakaba Hospital, 28-13 Minami-Chuo, Tsu, Mie 514-0832, Japan ; Department of Gastrointestinal and Pediatric Surgery, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: Department of Gastrointestinal and Pediatric Surgery, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Kusunoki