Cheon, J H; Kim, Y-S; Lee, I-S; Chang, D K; Ryu, J-K; Lee, K J; Moon, J-S; Park, C H; Kim, J-O; Shim, K-N; Choi, C H; Cheung, D Y; Jang, B I; Seo, G-S; Chun, H-J; Choi, M-G
Endoscopy
2007Dec ; 39 ( 12 ) :1046-52.
PMID : 18072054
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Cheon, J H -
Kim, Y-S -
Lee, I-S -
Chang, D K -
Ryu, J-K -
Lee, K J -
Moon, J-S -
Park, C H -
Kim, J-O -
Shim, K-N -
Choi, C H -
Cheung, D Y -
Jang, B I -
Seo, G-S -
Chun, H-J -
Choi, M-G -
ABSTRACT
BACKGROUND AND STUDY AIMS: 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. PATIENTS AND
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.
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MESH
Adult, Aged, Aged, 80 and over, Capsule Endoscopes/*adverse effects, Capsule Endoscopy/*adverse effects/methods, Equipment Failure, Female, Foreign Bodies/*epidemiology/etiology, Health Care Surveys, Humans, Incidence, Intestinal Diseases/*diagnosis, Intestinal Obstruction/*epidemiology/etiology, *Intestine, Small, Korea, Logistic Models, Male, Middle Aged, Multivariate Analysis, Predictive Value of Tests, Probability, Prognosis, Retrospective Studies, Risk Assessment
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