Incidence, clinical outcomes, and therapeutic approaches of capsule endoscopy-related adverse events in a large study population.

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.

• Authors: 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
• Journal: Revista espanola de enfermedades digestivas (Rev Esp Enferm Dig) Vol. 107 Issue 12 Pg. 745-52 (Dec 2015) ISSN: 1130-0108 [Print] Spain
• PMID: 26671587 (Publication Type: Evaluation Study, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Capsule Endoscopy (adverse effects, instrumentation)
• Female
• Foreign Bodies (epidemiology, etiology, therapy)
• Humans
• Incidence
• Intestine, Small (diagnostic imaging)
• Male
• Middle Aged
• Respiratory Aspiration (epidemiology, etiology, therapy)
• Retrospective Studies
• Risk Factors
• Spain
• Treatment Outcome
• Young Adult