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Can we predict spontaneous capsule passage after retention? A nationwide study to evaluate the incidence and clinical outcomes of capsule retention.

Authors
Cheon, JH; Kim, YS; Lee, IS; Chang, DK; Ryu, JK; Lee, KJ; Moon, JS; Park, CH; Kim, JO; Shim, KN; Choi, CH; Cheung, DY; Jang, BI; Seo, GS; Chun, HJ; Choi, MG
Citation
Endoscopy, 39(12):1046-1052, 2007
Journal Title
Endoscopy
ISSN
0013-726X1438-8812
Abstract
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.
MeSH terms
AdultAgedAged, 80 and overCapsule Endoscopes/adverse effects*Capsule Endoscopy/adverse effects*Capsule Endoscopy/methodsEquipment FailureFemaleForeign Bodies/epidemiology*Foreign Bodies/etiologyHealth Care SurveysHumansIncidenceIntestinal Diseases/diagnosis*Intestinal Obstruction/epidemiology*Intestinal Obstruction/etiologyIntestine, Small*KoreaLogistic ModelsMaleMiddle AgedMultivariate AnalysisPredictive Value of TestsProbabilityPrognosisRetrospective StudiesRisk Assessment
DOI
10.1055/s-2007-966978
PMID
18072054
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
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