Retención de cápsula endoscópica: frecuencia, causas y análisis de factores de riesgo en 244 procedimientos consecutivos
DOI:
https://doi.org/10.52787/agl.v53i2.307Palabras clave:
Cápsula endoscópica, retención, intestino delgado, endoscopíaResumen
Introducción. La cápsula endoscópica es fundamental en la investigación del intestino delgado. La retención es su principal complicación.
Objetivo. Analizar la frecuencia y los factores de riesgo relacionados con la retención de cápsula.
Métodos. Fueron analizados 244 exámenes consecutivos. El
evento fue definido como “retención definitiva” si la cápsula permanecía en el intestino delgado durante 3 semanas después del procedimiento y como “retención temporal” cuando al finalizar el procedimiento la cápsula aún se mantenía dentro del intestino delgado, pero era eliminada en los próximos días de manera espontánea. Los factores de riesgo relacionados con la retención fueron estenosis inflamatorias de intestino delgado, tumores y divertículos de gran tamaño.
Resultados. De 244 exámenes, se encontraron lesiones en 164 (67,2%) y, de éstas, 130 en el intestino delgado. Presentaron retención definitiva y temporal 5 y 2 pacientes respectivamente. Tenían factores de riesgo 44 casos. En 7 (15,9%) de ellos, hubo retención de la cápsula endoscópica, siendo retenciones definitivas en 5 casos. Los 2 casos de retención temporal se presentaron en el divertículo de Meckel y en la cicatriz de una úlcera péptica. Las 5 retenciones definitivas ocurrieron en 2 pacientes con Enfermedad de Crohn, 2 pacientes con estenosis por uso de antiinflamatorios y 1 paciente con estenosis actínica. En ninguno de los 11 casos de neoplasia de intestino delgado hubo retención de la cápsula.
Conclusión. No hubo retención de capsula endoscópica
en pacientes sin factores de riesgo. Se observó retención definitiva en aproximadamente una décima parte de todos los pacientes con factores de riesgo en intestino delgado. El reconocimiento de los factores de riesgo y su identificación antes del procedimiento son de suma importancia, especialmente en pacientes con sospecha de estenosis inflamatoria.
Citas
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Derechos de autor 2023 Carlos Saul, Guilherme Pereira Lima, Abdon Pacurucu Merchan, Julio C Pereira-Lima
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