Potential complications of capsule endoscopy

Background: Wireless capsule endoscopy (CE) is a safe and well tolerated method. The most important complication is the capsule retention during its passage in the small bowel.

Aim: To evaluate the complications of CE in our series of 40 patients.

Patients and Methods: Wireless capsule endoscope measuring 11×27mm was used. The data of 40 patients were evaluated who were examined for suspected small intestinal bleeding (32), suspected Crohn's disease (2) and Peutz-Jeghers syndrome (6).

Results: 3 complications were recognised in 40 cases. Asymptomatic capsule retention occurred in a patient with a history of previous small intestine surgery and a side to side ileal anastomosis. By CE examination an ileal ulcer causing significant stenosis and a long standing capsule retention was observed and the capsule was retrieved by surgery. In a patient with suspected Crohn's disease a tight stenosis obstructing the progression of the capsule caused transitional subileus and required steroid treatment. Finally the capsule was evacuated on the 5th day. In the third case the capsule remained in the oesophagus for several hours, before it moved into the stomach. Gastroscopy showed normal oesophagus. The patient remained asymptomatic, but the delay leaded to a non informative examination.

Conclusions: Currently recognised high risk factors for capsule retention are extensive Crohn's enteritis, and prior abdominal surgery. Unexpected reasons like motility abnormality may also delay the transit of the device and cause complications.