J Korean Soc Coloproctol.  2006 Jun;22(3):192-196.

Laparoscopy-assisted Surgical Removal of a Retained Wireless Capsule Endoscopy: A case report

Affiliations
  • 1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hkchun@smc.samsung.co.kr

Abstract

Occult bleeding of the gastrointestinal tract is a major cause of iron deficiency anemia. Even with endoscopic evaluation of the upper and the lower gastrointestinal tract in these patients, in 30~50% of the cases, the cause of bleeding still remains undiscovered. Wireless capsule endoscopy (WCE) is a novel method of evaluating the small bowel mucosa by using a small capsule equipped with a camera and transmission device. Complications of WCE include impaction within the gastrointestinal tract, sometimes requiring surgical removal. The authors report a case of capsule impaction in the small bowel in a patient evaluated for anemia due to occult gastrointestinal tract bleeding. The patient is a 19 year-old female with a history of anemia since age 4. The stool guaiac test was positive, but upper and lower gastrointestinal tract endoscopy showed no abnormalities, so WCE was done. A short segment of circular ulcers with lumen narrowing were seen in the distal jejunum. Seven days after ingestion of the capsule, the patient denied passage of the capsule. Small bowel enteroclysis was performed, and the capsule was seen along with a segment of lumen narrowing distal to the site of retention. Surgery was done, and upon laparoscopic examination, the entire bowel appeared normal. Retrieval of the capsule was done along with a resection of an 8 cm segment of the small bowel. Three linear ulcers were seen in the resected bowel specimen. Pathology revealed no evidence of Crohn's disease or tuberculosis. The patient is still on iron supplements, but her hemoglobin level remains stable at 11~12 g/dl.

Keyword

Wireless capsule endoscopy; Gastrointestinal tract bleeding; Surgical complications

MeSH Terms

Anemia
Anemia, Iron-Deficiency
Capsule Endoscopy*
Crohn Disease
Eating
Endoscopy
Female
Gastrointestinal Tract
Guaiac
Hemorrhage
Humans
Iron
Jejunum
Lower Gastrointestinal Tract
Mucous Membrane
Pathology
Tuberculosis
Ulcer
Young Adult
Guaiac
Iron
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