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)

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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.