title: Symptomatic Patency Capsule Retention in Suspected Crohn's Disease.
abstract: The main limitation of capsule endoscopy is the risk of capsule retention. In patients with suspected Crohn's disease, however, this complication is rare, and if a small bowel stenosis is not reliably excluded, small bowel patency can be confirmed with the Pillcam patency capsule. We present two patients examined for suspected Crohn's disease who experienced significant symptoms from a retained patency capsule. Both patients had Crohn's disease located in the terminal ileum. In one patient, the patency capsule caused abdominal pain and vomiting and was visualized at magnetic resonance enterography 9 days after ingestion. Symptoms improved spontaneously. Another patient experienced small bowel perforation with severe peritonitis caused by an intact patency capsule wedged in a small bowel stricture. We conclude that the Pillcam patency capsule is an effective modality for securing small bowel patency prior to capsule endoscopy. However, it should be emphasized that delayed patency capsule degradation and symptomatic capsule retention is a rare but potentially severe complication which should be treated aggressively, either medically or endoscopically.
authors.affiliation: Department of Internal Medicine, Section of Gastroenterology, Lillebaelt Hospital Vejle, Denmark.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Rasmussen
authors.affiliation: Department of Internal Medicine, Section of Gastroenterology, Lillebaelt Hospital Vejle, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Nathan
authors.affiliation: Department of Internal Medicine, Section of Gastroenterology, Lillebaelt Hospital Vejle, Denmark michael.dam.jensen@rsyd.dk.
authors.forename: Michael Dam
authors.initials: MD
authors.lastname: Jensen
mesh_terms: D000368:Aged; D053704:Capsule Endoscopy / Q000009:adverse effects*; D003424:Crohn Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D014057:Tomography, X-Ray Computed
keywords: Crohn’s disease; capsule endoscopy; capsule retention