Chen Hongchao, Zhang Zhe, Zhang Muhan, Wang Dandan, Jia Mengmeng, Feng Baisui
Gastroenterology and Hepatology, The Second Affiliated Hospital of Zhengzhou University, NO.2 Jingba Road, Zhengzhou 450003, Henan, China.
Gastroenterology and Hepatology, The Second Affiliated Hospital of Zhengzhou University, NO.2 Jingba Road, Zhengzhou 450003, Henan, China.
Int J Surg Case Rep. 2022 Jun;95:107197. doi: 10.1016/j.ijscr.2022.107197. Epub 2022 May 13.
Capsule endoscopy has been widely used in the diagnosis of small bowel diseases. Most CE can be smoothly excreted through the digestive tract. However, very few retention of CE may happen.
A 64-year-old man had been suffering from intermittent abdominal pain for 10 years. Capsule endoscopy was performed in local hospital 4 years ago. He was initially diagnosed with Crohn's disease and started on treatment. CTE and X-ray film of abdomen showed a suspected capsule endoscopy on the right side of pelvic cavity. Surgery was performed to remove the capsule. After the surgical treatment, no gastrointestinal symptoms relapsed for 9 months.
It isn't uncommon for capsule endoscopy to be detained in Crohn's disease, because Strictures are the commonest complication of Crohn's disease. In order to prevent intestinal retention of capsule endoscopy, risk assessment should be carried out before capsule endoscopy. If detained CE isn't removed successfully by drug therapy and endoscopic therapy, surgery treatment has to be considered.
In the present case, capsule endoscopy was found in the small intestine after 4 years, and the reason is worth pondering. We strongly recommend performing routine CTE, MRE and patency capsule examination before capsule endoscopy for patients suspected of stenosis. Routine abdominal X-ray film after examination is also useful for timely detection of capsule retention.
胶囊内镜已广泛应用于小肠疾病的诊断。大多数胶囊内镜可顺利通过消化道排出。然而，胶囊内镜滞留的情况非常少见。
一名64岁男性，间歇性腹痛10年。4年前在当地医院行胶囊内镜检查。最初诊断为克罗恩病并开始治疗。腹部CTE和X线片显示盆腔右侧疑似有胶囊内镜。行手术取出胶囊。手术治疗后，9个月内无胃肠道症状复发。
胶囊内镜滞留在克罗恩病中并不少见，因为狭窄是克罗恩病最常见的并发症。为防止胶囊内镜肠道滞留，在进行胶囊内镜检查前应进行风险评估。如果药物治疗和内镜治疗未能成功取出滞留的胶囊内镜，则必须考虑手术治疗。
在本病例中，4年后在小肠中发现了胶囊内镜，其原因值得深思。我们强烈建议对疑似狭窄的患者在进行胶囊内镜检查前常规行CTE、MRE和通畅性胶囊检查。检查后常规腹部X线片也有助于及时发现胶囊滞留。
