Gutiérrez LI, García WRP, Saavedra PSR, Quijano OF

Language: Spanish
References: 22
Page: 309-313
PDF size: 298.73 Kb.

ABSTRACT

Very few cases of small bowel perforation due to video capsule endoscopy retention have been reported, most of them occur in patients with Crohn's disease. Based on the few reported cases of asymptomatic capsule retention in patients with radiation enteritis, it has been hypothesized that a history of radiation therapy might be a potential risk factor for capsule-related obstruction. We present the case of a 74-year-old woman with a history of radiotherapy on the abdomen as part of the treatment of an epidermoid carcinoma of the anal canal, who presented with suspected small bowel bleeding 14 years after the cancer treatment. She underwent a video capsule endoscopy after having normal findings in upper and lower endoscopy. The Video capsule endoscopy findings reported circumferential intestinal ulcers that provoke stenosis that caused capsule retention. Two weeks after swallowing the capsule the patient presented acute bowel perforation. During the surgical exploration, a sealed ileum perforation was found proximal to the stricture of the terminal ileum in which the patency capsule was impacted. Resection with side-to-side ileum-to-ileum anastomosis with staples was performed. Pathological examination showed transmural inflammation with ulcers and extensive fibrosis, consistent with radiation enteritis, as well as an area of ileal perforation.

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