Capsule endoscopy: a dangerous but diagnostic tool

Abstract

Current guidelines advocate the use of capsule endoscopy (CE) when gastroscopy and colonoscopy have failed to demonstrate the origin of occult gastrointestinal bleeding. CE has been used successfully in the diagnosis of a variety of conditions such as coeliac disease, polyposis syndromes and small bowel tumours, when routine investigations have failed to yield a diagnosis. In conditions where the diameter of the bowel lumen may be compromised, such as Crohn's disease, CE is contraindicated because of the risk of retention and/or small bowel obstruction. Here we present an unusual case where CE resulted in small bowel obstruction and perforation in a segment of small bowel which had become inflamed secondary to a carcinoid tumour.

Figure 1

Plain abdominal X-ray showing incomplete small bowel obstruction. The retained capsule is also visible in the left side of the pelvis.

Figure 2

Resected bowel. The capsule is seen impacted proximal to the ileocaecal valve.