Omori Teppei, Hara Toshifumi, Murasugi Shun, Kambayashi Harutaka, Sasaki Yu, Koroku Miki, Yonezawa Maria, Morishita Keiichi, Nakamura Shinichi, Tokushige Katsutoshi
Institute of Gastroenterology Tokyo Women's Medical University Tokyo Japan.
Department of Gastroenterology Hachioji Digestive Disease Hospital Tokyo Japan.
DEN Open. 2023 Aug 24;4(1):e288. doi: 10.1002/deo2.288. eCollection 2024 Apr.
A 60-year-old man presented with a suspected small intestinal tumor on positron-emission tomography-computed tomography. Small bowel capsule endoscopy (SBCE) was planned for close examination of the small intestine. To avoid retention of the SBCE due to strictures, a patency capsule (PC) was first used to evaluate patency. However, PC discharge was not visually confirmed during the 24-h period. No obvious PC was observed on plain abdominal radiography performed in the standing position. The patient underwent SBCE, assuming that the PC had been shed inconspicuously. SBCE revealed a neoplastic lesion with stenosis at a site thought to be the upper small intestine and remained stagnant at the same site for the duration of the battery. In addition, in the SBCE image, a PC shell was captured in the intestinal tract on the oral side of the stenosis. When the pre-SBCE plain abdominal radiograph was enlarged to confirm the details, PC was observed in the lateral and decubitus views as a dissolved shell only. To the best of our knowledge, no previous report has described the complete dissolution of a PC leaving only its shell during a 30-hour patency evaluation period. This case illustrates that, in the absence of visual confirmation of a PC discharge, PC may have remained in the body due to premature dissolution. Additional examinations or plain X-ray imaging should be performed to confirm this, with no preconceived notions that the PC will not dissolve within 30 hours of administration.
一名60岁男性在正电子发射断层扫描-计算机断层扫描中发现疑似小肠肿瘤。计划进行小肠胶囊内镜检查（SBCE）以仔细检查小肠。为避免因狭窄导致SBCE滞留，首先使用了通畅性胶囊（PC）来评估通畅性。然而，在24小时内未肉眼确认PC排出。站立位腹部平片未观察到明显的PC。患者接受了SBCE，假定PC已不显眼地排出。SBCE显示在被认为是小肠上段的部位有一个伴有狭窄的肿瘤性病变，并且在电池续航期间一直停滞在同一部位。此外，在SBCE图像中，在狭窄部位口侧的肠道中捕获到了一个PC外壳。当放大SBCE前的腹部平片以确认细节时，仅在侧位和卧位视图中观察到PC为溶解后的外壳。据我们所知，以前没有报告描述过在30小时的通畅性评估期内PC完全溶解仅留下其外壳的情况。该病例表明，在没有肉眼确认PC排出的情况下，PC可能由于过早溶解而留在体内。应进行额外检查或腹部X线平片成像以确认这一点，不要先入为主地认为PC在给药后30小时内不会溶解。
