Surgical Management of a Complicated Retained Endoscopic Capsule. A Case Report

Abstract

Currently, capsule endoscopy is the gold standard for evaluating small bowel diseases. Its most common use is to investigate intestinal bleeding of unknown origin, although its indications have been expanded to include the investigation of Crohn's disease, iron deficiency anemia, malabsorption syndromes, intestinal lesions related to the use of nonsteroidal anti-inflammatory drugs, small bowel tumors, and surveillance of polyposis syndromes. The main risk associated with its use is capsule retention. We present the case of a patient who was admitted to the emergency room due to acute abdominal pain and reported that four months earlier she had undergone a capsule endoscopy as part of an investigation into her anemia. Imaging studies revealed a metallic object in the colon and hydropneumoperitoneum. With a diagnosis of acute perforated abdomen, surgical intervention was decided upon, and a right hemicolectomy was performed. The pathological study reported the presence of an intraluminal endoscopic camera. The patient was discharged on the seventh day without complications. This case is presented to highlight the risks of capsular retention, which can lead to acute complications such as obstruction or perforation, emphasizing the importance of early diagnosis so that surgery is not necessary.