Year 2015 / Volume 107 / Number 12
Original
Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population

745-752

DOI: 10.17235/reed.2015.3820/2015

Ignacio Fernández-Urién, Cristina Carretero, Begoña González, Vicente Pons, Ángel Caunedo, Julio Valle, Eduardo Redondo-Cerezo, Antonio López-Higueras, Mariano Valdés, Pedro Menchen, Pedro Fernández, Miguel Muñoz-Navas, Javier Jiménez, Juan Manuel Herrerías,

Abstract
Introduction: Capsule endoscopy (CE) has become a first-line tool for small bowel (SB) examination. However, adverse events (AEs), such as CE retention or aspiration, may occur. The aims of this study were to evaluate incidence, clinical outcomes and therapeutic approaches of CE-related AEs in the largest series published to date. Methods: Data from 5428 procedures performed at 12 institutions between August 2001 and January 2012 were retrospectively analyzed. Baseline patient characteristics; procedure; type, localization and symptoms before/after AEs; previous patency tests performed; therapeutic management and patient´s outcome were recorded. Results: The overall incidence of CE-related AEs was 1.9%: 2.0% for SB, 0.9% for esophageal and 0.5% for colon CE. The incidence of capsule retention was significantly higher than capsule aspiration (1.87% vs. 0.003%; p < 0.05), in patients suffering from inflammatory bowel disease (IBD) than in obscure GI bleeding (OGIB) (3.3% vs. 1.5%; p < 0.05) and in patients with the combination of nausea/vomiting, abdominal pain and distension. The SB was the most frequent localization of retention (88.2%). The use of patency tests -except for Patency© capsule- before CE was not a good predictor for AEs. Most of the patients with AEs developed no or mild symptoms (97%) and were managed by non-surgical methods (64.4%). Conclusions: CE-related AEs are uncommon and difficult to predict by imagiological examinations. SB retention, that is usually asymptomatic, is the most frequent AE. In absence of symptoms, non-surgical management of CE-related AEs is recommended.
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10/12/2015 20:03:11
Muy buen artículo. Enhorabuena a los autores.


References
1. Iddan G, Meron G, Glukhovsky A, et al. Wireless capsule endoscopy. Nature 2000;405:417. DOI: 10.1038/35013140
2. Liao Z, Gao R, Xu C, Li, et al. Indications and detection, completion and retention rates of small-bowel capsule endoscopy: a systematic review. Gastrointest Endosc 2010;71:280-6. DOI: 10.1016/j.gie.2009.09.031
3. Neumann H, Fry LC, Neurath MF. Review article on current applications and future concepts of capsule endoscopy. Digestion 2013;87:91-9. DOI: 10.1159/000345346
4. Hale MF, Sidhu R, McAlindon ME. Capsule endoscopy: Current practice and future directions. World J Gastroenterol 2014;20:7752-9. DOI: 10.3748/wjg.v20.i24.7752
5. Goldstein JL, Eisen GM, Lewis B, et al. Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo. Clin Gastroenterol Hepatol 2005;3:133-41. DOI: 10.1016/S1542-3565(04)00619-6
6. Cheon JH, Kim YS, Lee IS, et al; Korean Gut Image Study Group. Can we predict spontaneous capsule passage after retention? A nationwide study to evaluate the incidence and clinical outcomes of capsule retention. Endoscopy 2007;39:1046-52. DOI: 10.1055/s-2007-966978
7. Li F, Gurudu SR, De Petris G, et al. Retention of the capsule endoscope: a single-center experience of 1000 capsule endoscopy procedures. Gastrointest Endosc 2008;68:174-80. DOI: 10.1016/j.gie.2008.02.037
8: Cheifetz AS, Lewis BS. Capsule endoscopy retention: is it a complication? J Clin Gastroenterol. 2006;40:688-91. DOI: 10.1097/00004836-200609000-00005
9. Nathan SR, Biernat L. Aspiration--an important complication of small-bowel video capsule endoscopy. Endoscopy. 2007;39 (Suppl 1):E343. DOI: 10.1055/s-2007-995327
10. Um S, Poblete H, Zavotsky J. Small bowel perforation caused by an impacted endocapsule. Endoscopy. 2008;40 (Suppl 2):E122-3. DOI: 10.1055/s-2007-995694
11. Tanaka Y, Motomura Y, Akahoshi K, et al. Capsule endoscopic detection of bleeding Meckel's diverticulum, with capsule retention in the diverticulum. Endoscopy. 2010;42 (Suppl 2):E199-200. DOI: 10.1055/s-0030-1255696
12. Ferreira F, Bastos P, Cardoso H, et al. Retention of endoscopic capsule in an umbilical hernia. 19. Endoscopy. 2011;43 (Suppl 2) UCTN:E111-2. DOI: 10.1055/s-0030-1256141
13. Ding NS, Hair C, De Cruz P, et al. Education and Imaging. Gastrointestinal: symptomatic bronchial aspiration of capsule endoscope - a significant complication. J Gastroenterol Hepatol 2013;28:761. DOI: 10.1111/jgh.12173
14. Cave D, Legnani P, de Franchis R, et al. ICCE consensus for capsule retention. Endoscopy 2005;37:1065-7. DOI: 10.1055/s-2005-870264
15. Rondonotti E, Herrerias JM, Pennazio M, et al. Complications, limitations and failures of capsule endoscopy: a review of 733 cases. Gastrointest Endosc 2005;62:712-6. DOI: 10.1016/j.gie.2005.05.002
16. Rondonotti E, Villa F, Mulder CJJ, et al. Small bowel capsule endoscopy in 2007: Indications, risks and limitations. World J Gastroenterol 2007;13:6140-9. DOI: 10.3748/wjg.13.6140
17. Höög CM, Bark LA, Arkani J, et al. Capsule retentions and incomplete capsule endoscopy examinations: an analysis of 2300 examinations. Gastroenterol Res Pract 2012;2012:518718. DOI: 10.1155/2012/518718
18. Pezzoli A, Fusetti N, Carella A, et al. Asymptomatic bronchial aspiration and prolonged retention of a capsule endoscope: a case report. J Med Case Rep 2011;5:341. DOI: 10.1186/1752-1947-5-341
19. Girdhar A, Usman F, Bajwa A. Aspiration of capsule endoscope and successful bronchoscopic extraction. J Bronchology Interv Pulmonol 2012;19:328-31. DOI: 10.1097/LBR.0b013e31826e3b53
20. de Franchis R, Eisen GM, Laine L, et al. Esophageal capsule endoscopy for screening and surveillance of esophageal varices in patients with portal hypertension. Hepatology 2008;47:1595-1603 DOI: 10.1002/hep.22227
21. Van Gossum A, Munoz Navas M, Fernandez-Urien I, et al. Capsule endoscopy versus colonoscopy for the detection of polyps and cancer. N Engl J Med 2009;361:264-70. DOI: 10.1056/NEJMoa0806347
22. Bhardwaj A, Hollenbeak CS, Pooran N. A meta-analysis of the diagnostic accuracy of esophageal capsule endoscopy for Barret´s esophagus in patients with gastroesophageal reflux disease. Am J Gastroenterol 2009;104:1533-9. DOI: 10.1038/ajg.2009.86
23. Ladas SD, Triantafyllou K, Spada C, et al; ESGE Clinical Guidelines Committee. European Society of Gastrointestinal Endoscopy (ESGE): recommendations (2009) on clinical use of video capsule endoscopy to investigate small-bowel, esophageal and colonic diseases. Endoscopy. 2010;42:220-7. DOI: 10.1055/s-0029-1243968.
24. Cheifetz AS, Kornbluth AA, Legnani P, et al. The risk of retention of the capsule in patients with known or suspected Crohn´s disease. Am J Gastroenterol 2006;101:2218-22. DOI: 10.1111/j.1572-0241.2006.00761.x
25. Cotter J, Castro FD, Moreira MJ, et al. Tailoring Crohn's Disease tretament: the impact of small bowel capsule endoscopy. J Crohns Colitis 2014;8:1610-5. DOI: 10.1016/j.crohns.2014.02.018
26. Herrerías JM, Caunedo A, Rodríguez-Téllez M, et al. Capsule endoscopy in patients with suspected Crohn's disease and negative endoscopy. Endoscopy. 2003;35:564-8. DOI: 10.1055/s-2003-40241.
27. Girelli CM, Porta P, Malacrida V, et al. Clinical outcome of patients examined by capsule endoscopy for suspected small bowel Crohn's disease. Dig Liver Dis. 2007;39:148-54. DOI: 10.1016/j.dld.2006.10.018
28. Arguelles-Arias F, Rodriguez-Oballe J, Duarte-Chang C, et al. Capsule endoscopy in small bowel Crohn´s disease. Gastroenterol Res Pract 2014;2014:529136. DOI: 10.1155/2014/529136
29. Skovsen AP, Burchart J, Burgdorf SK. Capsule endoscopy: a cause of late small bowel obstruction and perforation. Case Rep Surg 2013;2013:458108. DOI: 10.1155/2013/458108
30. Wiarda BM, Mensink PBF, Heine DGN, et al. Small bowel Crohn's disease: MR enteroclysis and capsule endoscopy compared to balloon-assisted enteroscopy.Abdom Imaging 2012;37:397-408. DOI: 10.1007/s00261-011-9816-8
31. Spada C, Riccioni ME, Costamagna G. The new, dissolving patency capsule: a safe and effective tool to avoid the complication of retained video capsules. J Clin Gastroenterol 2008;42:761-2. DOI: 10.1097/MCG.0b013e31802e7f11
32. Herrerias JM, Leighton JA, Costamagna G, et al. Agile patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy. Gastrointest Endosc 2008; 67:902-9. DOI: 10.1016/j.gie.2007.10.063
33. Postgate AJ, Burling D, Gupta A, et al. 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. DOI: 10.1007/s10620-008-0210-5
34. Shiotani A, Hata J, Manabe N, et al. Clinical relevance of patency capsule combined with abdominal ultrasonography to detect small bowel strictures. Eur J Gastroenterol Hepatol 2014;26:1434-8. DOI: 10.1097/MEG.0000000000000225
35. Sears DM, Avots-Avontins A, Culp K, et al. Frequency and clinical outcome of capsule retention during capsule endoscopy for GI bleeding of obscure origin. Gastrointest Endosc 2004;60:822-7. DOI: 10.1016/S0016-5107(04)02019-X
36. Harrington C, Rodgers C. The longest duration of retention of a video capsule. BMJ Case Rep 2014;Jul 8;2014. DOI: 10.1136/bcr-2013-203241
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Fernández-Urién I, Carretero C, González B, Pons V, Caunedo Á, Valle J, et all. Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population. 3820/2015


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Publication history

Received: 23/04/2015

Accepted: 08/09/2015

Online First: 26/10/2015

Published: 03/12/2015

Article revision time: 133 days

Article Online First time: 186 days

Article editing time: 224 days


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