title: Capsule retention caused by duodenal metastases from primary appendiceal adenocarcinoma.
abstract: Metastatic small bowel cancers are extremely rare in clinical practice. Primary appendiceal adenocarcinoma with gastrointestinal metastasis is seldom reported in the literature. Here, we describe the case of an 80-year-old male patient with primary appendiceal adenocarcinoma, who presented to China Medical University Hospital with mid-gastrointestinal tract bleeding. Capsule endoscopy revealed stenotic bowel lumen, but the capsule was retained in the distal duodenum. Double-balloon enteroscopy demonstrated erosive and erythematous mucosa in the region of capsule retention. The retained capsule was retrieved successfully by using an electrosurgical snare. Histological examination and immunohistochemical staining of the biopsy specimen from the duodenal lesion strongly supported the diagnosis of metastatic appendiceal adenocarcinoma.
authors.affiliation: School of Medicine, China Medical University, Taichung, Taiwan, R.O.C.; Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.; Taiwan Society of Inflammatory Bowel Disease, Taiwan, R.O.C.; Taiwan Association for the Study of Small Intestinal Diseases, Taiwan, R.O.C.
authors.forename: Jen-Wei
authors.initials: JW
authors.lastname: Chou
authors.affiliation: School of Medicine, China Medical University, Taichung, Taiwan, R.O.C.; Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.
authors.forename: Ken-Sheng
authors.initials: KS
authors.lastname: Cheng
keywords: Capsule endoscopy; Capsule retention; Double-balloon enteroscopy; Metastatic small bowel cancer; Primary appendiceal adenocarcinoma