title: Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population.
abstract: BACKGROUND
  Capsule endoscopy (CE) has become a first-line tool for small bowel (SB) examination. However, adverse events (AEs), such as CE retention or aspiration, may occur. The aims of this study were to evaluate incidence, clinical outcomes and therapeutic approaches of CE-related AEs in the largest series published to date.
  
  
  METHODS
  Data from 5428 procedures performed at 12 institutions between August 2001 and January 2012 were retrospectively analyzed. Baseline patient characteristics; procedure; type, localization and symptoms before/after AEs; previous patency tests performed; therapeutic management and patient's outcome were recorded.
  
  
  RESULTS
  The overall incidence of CE-related AEs was 1.9%: 2.0% for SB, 0.9% for esophageal and 0.5% for colon CE. The incidence of capsule retention was significantly higher than capsule aspiration (1.87% vs. 0.003%; p < 0.05), in patients suffering from inflammatory bowel disease (IBD) than in obscure GI bleeding (OGIB) (3.3% vs. 1.5%; p < 0.05) and in patients with the combination of nausea/vomiting, abdominal pain and distension. The SB was the most frequent localization of retention (88.2%). The use of patency tests -except for Patency© capsule- before CE was not a good predictor for AEs. Most of the patients with AEs developed no or mild symptoms (97%) and were managed by non-surgical methods (64.4%).
  
  
  CONCLUSIONS
  CE-related AEs are uncommon and difficult to predict by imagiological examinations. SB retention, that is usually asymptomatic, is the most frequent AE. In absence of symptoms, non-surgical management of CE-related AEs is recommended.
authors.affiliation: Digestivo, Complejo Hospitalario de Navarra, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Fernández-Urién
authors.affiliation: Universidad de Navarra.
authors.forename: Cristina
authors.initials: C
authors.lastname: Carretero
authors.affiliation: Hospital Clínic. Barcelona.
authors.forename: Begoña
authors.initials: B
authors.lastname: González
authors.affiliation: Hospital Universitario y Politécnico La Fe. Valencia.
authors.forename: Vicente
authors.initials: V
authors.lastname: Pons
authors.affiliation: Hospital Universitario Virgen Macarena. Sevilla.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Caunedo
authors.affiliation: Complejo Hospitalario de Toledo. Toledo.
authors.forename: Julio
authors.initials: J
authors.lastname: Valle
authors.affiliation: Hospital Virgen de las Nieves. Granada.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Redondo-Cerezo
authors.affiliation: Hospital General Universitario Morales Meseguer. Murcia.
authors.forename: Antonio
authors.initials: A
authors.lastname: López-Higueras
authors.affiliation: Hospital Universitario Virgen de la Arrixaca. Murcia.
authors.forename: Mariano
authors.initials: M
authors.lastname: Valdés
authors.affiliation: Hospital General Universitario Gregorio Marañon Hospital. Madrid.
authors.forename: Pedro
authors.initials: P
authors.lastname: Menchen
authors.affiliation: . Hospital Universitario Marqués de Valdecilla. Santander.
authors.forename: Pedro
authors.initials: P
authors.lastname: Fernández
authors.affiliation: Universidad de Navarra.
authors.forename: Miguel
authors.initials: M
authors.lastname: Muñoz-Navas
authors.affiliation: Complejo Hospital de Pamplona. Navarra.
authors.forename: Javier
authors.initials: J
authors.lastname: Jiménez
authors.affiliation: Hospital Universitario Virgen Macarena. Sevilla.
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Herrerías
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D005547:Foreign Bodies / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D053120:Respiratory Aspiration / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D016896:Treatment Outcome; D055815:Young Adult