Endoscopy 2007; 39(12): 1046-1052
DOI: 10.1055/s-2007-966978
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Can we predict spontaneous capsule passage after retention? A nationwide study to evaluate the incidence and clinical outcomes of capsule retention

J.  H.  Cheon1 , Y.-S.  Kim2 , I.-S.  Lee3 , D.  K.  Chang4 , J.-K.  Ryu5 , K.  J.  Lee6 , J.-S.  Moon7 , C.  H.  Park8 , J.-O.  Kim9 , K.-N.  Shim10 , C.  H.  Choi11 , D.  Y.  Cheung3 , B.  I.  Jang12 , G.-S.  Seo13 , H.-J.  Chun2 , M.-G.  Choi3 , for the Korean Gut Image Study Group
  • 1Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul; Korea
  • 2Korea University College of Medicine, Seoul; Korea
  • 3Catholic University College of Medicine, Seoul; Korea
  • 4SungKyunkwan University College of Medicine and Samsung Medical Center, Seoul; Korea
  • 5Seoul National University College of Medicine, Seoul; Korea
  • 6Ajou University College of Medicine, Suwon; Korea
  • 7Inje University College of Medicine, Seoul; Korea
  • 8Hallym University College of Medicine, Anyang; Korea
  • 9Soon Chun Hyang University College of Medicine, Seoul; Korea
  • 10Ewha Womans University School of Medicine, Seoul; Korea
  • 11Chung Ang University College of Medicine, Seoul; Korea
  • 12YeungNam University College of Medicine, Daegu; Korea
  • 13Wonkwang University College of Medicine, Iksan; Korea; Korea
Further Information

Publication History

submitted 26 March 2007

accepted after revision 30 July 2007

Publication Date:
10 December 2007 (online)

Preview

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.

References

D. K. Chang, MD, PhD 

Division of Gastroenterology
Department of Medicine
Sungkyunkwan University School of Medicine
Samsung Medical Center

50 Irwon-dong
Gangnam-gu
Seoul 135-710
Korea

Fax: +82-2-34103849

Email: dkchang@skku.edu