2019, Number S1
<< Back Next >>
Cir Cir 2019; 87 (S1)
Bowel obstruction due to video capsule endoscopy in a patient with Crohn’s disease
Guevara-Morales GR, Castellanos-Juárez JC
Language: Spanish
References: 17
Page: 48-52
PDF size: 307.16 Kb.
ABSTRACT
Background: The retention of the endoscopic capsule (EC) is a serious complication and exceptionally, acute intestinal obstruction
is conditioned.
Clinical case: 64 years-old man, previously treated by gastroenterology for Crohn’s disease. With good
initial response to pharmacological treatment for 6 weeks, subsequently with the onset of pain and symptoms not explained
by colonoscopy. EC was performed, presenting at 48 hours bowel obstruction symptoms with data of systemic inflammatory
response and peritoneal irritation. Exploratory laparotomy with bowel resection and side-to-side stapled anastomosis was
performed, histopathology report confirmed obstruction of the bowel lumen due to impacted EC in ileal stenosis area. In the
immediate postoperative period with good evolution. At 8 weeks of the procedure, he went for an enterocutaneous fistula,
which had a good response to conservative treatment.
Conclusion: The rate of retention of CE in Crohn’s disease is 5-6%,
prior to its use, it is recommended to perform imaging studies to evaluate the bowel permeability, however negative studies
do not exclude the presence of stenosis. In cases where intestinal resection is indicated, it is recommended to be wide with
side-to-side stapled anastomosis to reduce the risk of recurrence of the disease.
REFERENCES
Cave D, Legnani P, de Franchis R, Lewis S. ICCE consensus for capsule retention. Endoscopy. 2005;37:1065-7.
Rezapour M, Amadi C, Gerson LB. Retention associated with video capsule endoscopy: systematic review and meta-analysis. Gastrointest Endosc. 2017;85:1157-68.
Enns RA, Hookey L, Armstrong D, Berstein C, Heitman S, Teshima C, et al. Clinical practice guidelines for the use of video capsule endoscopy. Gastroenterology. 2017;152:497-514.
Lin OS, Brandabur JJ, Schembre DB, Soon MS, Kozarek RA. Acute symptomatic small bowel obstruction due to capsule impaction. Gastrointestinal Endoscopy. 2007;65(4):725–728.
De Palma GD, Masone S, Persico M, Siciliano S, Salvatori F, Maione F, et al. Capsule impaction presenting as acute small bowel perforation: a case series. J Medical Case Reports. 2012;6:121.
Sasmal PK, Das PC, Tantia O, Patle N, Khanna S, Sen B. Acute small intestinal obstruction—an unusual complication of capsule endoscopy. Indian J Surg. 2015;77(Suppl 1):21-23.
Sawai K, Goi T, Takegawa Y, Ozaki Y, Taguchi S, Kurebayashi H, et al. Acute small bowel perforation caused by obstruction of a novel tag-less AgileTM patency capsule. Case Rep Gastroenterol. 2018;12(2):337-343.
Postgate AJ, Burling D, Gupta A, Fitzpatrick A, Fraser C. Safety, reliability and limitations of the given patency capsule in patients at risk of capsule retention: a 3-year technical review. Dig Dis Sci 2008;53:2732-8.
Frolkis AD, Dykeman J, Negrón ME, Debruyn J, Jette N, Fiest KM, et al. Risk of surgery for inflammatory bowel diseases has decreased over time: a systematic review and meta- analysis of population-based studies. Gastroenterology 2013; 145: 996-1006.
Cheifetz A, Sachar D, Lewis B. Small bowel obstruction: indication or contraindication for capsule endoscopy. Paper presented at the Digestive Disease Week meeting, May 15-20, 2004, New Orleans, Louisiana, USA.
Hyman N, Manchester TL, Osler T, Burns B, Cataldo PA. Anastomotic leaks after intestinal anastomosis: it’s later than you think. Ann Surg 2007; 245: 254-258.
Myrelid P, Marti-Gallostra M, Ashraf S, Sunde ML, Tholin M, Oresland T, et al. Complications in surgery for Crohn’s disease after preoperative antitumour necrosis factor therapy. Br J Surg. 2014; 101: 539-545.
Maguire L, Olariu A, Hicks C, Hodin R, Bordeianou L. Does TNF inhibitor treatment prior to surgery for small bowel crohn’s disease modulate disease severity and minimize surgical intervention? Dis Colon Rectum 2014; 57.
El-Hussuna A, Andersen J, Bisgaard T, Jess P, Henriksen M, Oehlenschlager J, et al. Biologic treatment or immunomodulation is not associated with postoperative anastomotic complications in abdominal surgery for Crohn’s disease. Scandinavian J Gastroenterol 2012; 47: 662-668.
Riss S, Bittermann C, Zandl S, Kristo I, Stift A, Papay P, et al. Short-term complications of wide- lumen stapled anastomosis after ileocolic resection for Crohn’s disease: who is at risk? Colorectal Dis 2010; 12.
He X, Chen Z, Huang J, Lian L, Rouniyar S, Wu X, et al. Stapled side- to-side anastomosis might be better than handsewn end-to- end anastomosis in ileocolic resection for Crohn’s disease: a meta- analysis. Dig Dis Sci 2014; 59: 1544-1551.
Muñoz-Juárez M, Yamamoto T, Wolff BG, Keighly MRB. Wide-lumen stapled anastomosis vs convencional end-to-end anastomosis in the treatment of Crohn ́s disease. Dis Colon Rectum 2001;44:20-26.