Department of Surgery, Raigmore Hospital, Inverness, UK.
BMC Gastroenterol. 2022 May 21;22(1):258. doi: 10.1186/s12876-022-02332-8.
Colon capsule endoscopy (CCE) is a non-invasive alternative to colonoscopy. The reported sensitivity and specificity of CCE for the detection of clinically significant colonic neoplasia is high. To date, there have been no reported cases of colorectal cancer (CRC) missed by CCE which were located in segments adequately visualised by the capsule.
We present the case of a 71-year-old female, who underwent CCE for new lower gastrointestinal symptoms. The CCE reported 17 polyps (largest size 10 mm) and angiodysplasia. A 40 mm caecal pole tumour, not detected by the CCE, was identified at follow up colonoscopy. Surgical resection was performed, and the pathology sample was reported as moderately differentiated adenocarcinoma, pT2 pN0 (0/19) M0, with no evidence of EMVI. The patient made an uneventful recovery. The caecal pole tumour was not definitively identified on retrospective review of the CCE images.
To date, this is the first published case of a CRC missed entirely by CCE. Further research is required to allow calculation of the post CCE interval CRC rate to allow comparison with colonoscopy and CT colonogram.
结肠胶囊内镜（CCE）是一种替代结肠镜检查的非侵入性方法。CCE 对检测临床显著结肠肿瘤的敏感性和特异性较高。迄今为止，尚未有报道称 CCE 遗漏了位于胶囊充分可视段的结直肠癌（CRC）。
我们报告了一例 71 岁女性患者，因新的下消化道症状而行 CCE 检查。CCE 报告发现 17 个息肉（最大尺寸为 10 毫米）和血管发育不良。在后续结肠镜检查中发现了 CCE 未检测到的 40 毫米盲肠末端肿瘤。进行了手术切除，病理样本报告为中度分化腺癌，pT2 pN0（0/19）M0，无 EMVI 证据。患者恢复顺利。在对 CCE 图像的回顾性复查中，无法明确确定盲肠末端肿瘤。
迄今为止，这是首例完全被 CCE 遗漏的 CRC 病例。需要进一步研究，以便能够计算 CCE 后 CRC 发生率，以便与结肠镜检查和 CT 结肠成像进行比较。
