Endoscopic Capsule Retention: Frequency, Causes and Risk Factors Analysis in 244 Consecutive Procedures

Introduction. Endoscopic capsule is central to the study of the small bowel. Retention is its main complication. Objective. To analyze the frequency and risk factors associated with capsule retention. Methods. 244 consecutive examinations were analyzed. The event was defined as “definitive retention” if the capsule remained in the small bowel for 3 weeks after the procedure, and as “temporary retention” if the capsule remained in the small bowel at the end of the procedure but was eliminated spontaneously in the following days. Risk factors associated with retention were inflammatory small bowel strictures, tumours and large diverticula. Result. Of 244 procedures, lesions were found in 164 (67.2%), 130 of which were in the small bowel. There were 5 and 2 patients with definitive and temporary retention, respectively. Forty-four cases had risk factors. In 7 (15.9%) there was retention of the endoscopic capsule, with definitive retention in 5 cases. The 2 cases of temporary retention occurred in Meckel's diverticulum and in peptic ulcer scar. The 5 cases of definitive retention occurred in 2 patients with Crohn’s disease, 2 patients with stenosis related with anti-inflammatory drugs use and 1 patient with actinic stenosis. None of the 11 cases of small bowel neoplasia had capsule retention. Conclusions. There was no endoscopic capsule retention inpatients without risk factors. Definitive retention was observed in approximately one-tenth of all patients with small bowel risk factors. Recognition of risk factors and their identification prior to the procedure is of utmost importance, especially in patients with suspected inflammatory strictures.