Complications of Small Bowel Capsule Endoscopy

Abstract

A novel diagnostic tool for assessment of the small bowel mucosal surface, capsule endoscopy (CE), is mostly indicated in cases of obscure gastrointestinal bleeding and in selected patients with chronic inflammatory diseases. Generally considered a safe procedure, CE may be occasionally complicated by bronchial aspiration or videocapsule retention. The latter occurrence is significantly more frequent in patients with inflammatory, neoplastic or postsurgical strictures and may require endoscopic or surgical removal. Plain abdominal radiographs are useful to detect and monitor the retained radio-opaque videocapsule and to detect signs of bowel obstruction or perforation. Conversely, the use of CT is hampered by beam-hardening artefacts originating from metallic parts of the videocapsule. A typical case of small bowel capsule retention in a patient with Crohn’s disease is presented. Recently, the availability of “patency test capsules” allowed patients with obstructive symptoms, suspected or established CD to safely undergo CE.