Korean J Gastroenterol.  2016 Apr;67(4):207-211. 10.4166/kjg.2016.67.4.207.

Capsule Endoscopy with Retention of the Capsule in a Duodenal Diverticulum: A Case Report

• Kim S
• Bae SS
• Chu HJ
• Park JH
• Kyung GC
• An HD
• Kim K
• Gang EG

• KMID: 2373426
• DOI: http://doi.org/10.4166/kjg.2016.67.4.207

Abstract

Capsule endoscopy is being increasingly recognized as a gold standard for diagnosing small bowel disease, but along with the increased usage, capsule retention is being reported more frequently. We report a case of capsule endoscopy retention in a diverticulum of the duodenal proximal third portion, which we treated by esophagogastroduodenoscopy. A 69-year-old male visited hospital with hematochezia. He had hypertension and dyslipidemia for several years, and was taking aspirin to prevent heart disease. CT and colonoscopy revealed a diverticulum in the third portion of the duodenum, rectal polyps, and internal hemorrhoids. Capsule endoscopy was performed but capsule impaction occurred. The capsule was later detected by CT in the diverticulum. Endoscopy was performed a day later and the capsule was removed using a net. A small bowel series was conducted after capsule removal, and no stenosis was found. The patient fully recovered and no recurrence of hematochezia was observed at his one month exam. This is the first case in Korea of capsule retention in a duodenal diverticulum, with successful removal by endoscopy.

Keyword

Duodenum; Diverticulum; Retention; Capsule endoscopy

MeSH Terms

Abdomen/diagnostic imaging
Aged
Capsule Endoscopy
Diverticulum/*diagnosis/diagnostic imaging
Endoscopy, Digestive System
Humans
Male
Tomography, X-Ray Computed

Figure

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  Fig. 1. Initial CT finding. The diverticulum in the proximal 3rd portion of duodenum was detected and its largest diameter was 4.5 cm (arrow).

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  Fig. 2. Capsule endoscopy findings. The capsule was impacted in the diverticulum, which contained multiple enteroliths at 3 hours after ingestion.

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  Fig. 3. Abdominal CT findings. Capsule retention in the diverticulum of duodenal 3rd portion (arrows).

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  Fig. 4. Esophagastroduodenoscopy findgins. (A) The capsule escaped the diverticulum naturally and was located on 3rd portion of duodenum (arrow). (B) Capsule removed using the net.

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  Fig. 5. Small bowel series finding after removing the capsule. Malrotation of small bowel and enlarged diverticulum are revealed, size was about 6.5 cm because of gas and barium fluid retention (arrows).

Reference

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