Case Report. A 71-year-old man was admitted to the department of gastroenterology with diffuse
abdominal pain. Through the previous 12 months, the patient had experienced episodes of
vomiting and watery
diarrhea of increasing intensity as well as
weight loss. The patient was evaluated with ultrasound, MRI, and subsequently a
capsule endoscopy. Six months later, the patient presented, and an abdominal CT-scan showed mechanical small bowel obstruction with suspicion of metallic
foreign body and perforation.
Laparotomy showed perforation,
stenosis, and
foreign body, approximately 5 cm from the ileocecal valve. A right
hemicolectomy and distal ileectomy (60 cm) with an
ileostomy were performed. On further inspection of resection, a
capsule endoscope was found impacted in a
stenosis. The
ileostomy was later reversed without complications. Conclusion. It is important to be aware of the possibility of
capsule retention, especially in patients with known or suspected
Crohn's disease, due to the propensity of
Crohn's disease to form
stenosis of the bowel. In cases where a
stenosis is suspected, it is warranted to perform a patency
capsule swallow before subjecting the patient to a
capsule endoscopy.