Complicated wireless capsule enteroscopy in a patient with Crohn's disease

Eur J Gastroenterol Hepatol. 2009 Aug;21(8):952-4. doi: 10.1097/MEG.0b013e3283200088.

Abstract

An 18-year-old male experienced a first episode of Crohn's disease with inflammation of the colon, stenosis of small intestine and a fistula of the anal sphincter. After resection of the fistula and 30 cm of proximal ileum the patient remained free of symptoms under medication with azathioprine and mesalazine for 6 years. Then, blood in the stool occurred. Diagnostic work-up - gastroscopy and colonoscopy 2004 and 2006, magnetic resonance enteroclysis 2004 and 2006 and wireless capsule enteroscopy 2006 - revealed slight inflammation in the ileum but no bleeding source. The bleeding ceased, but after 2 uneventful years abdominal cramps appeared and diagnostic work-up (magnetic resonance enteroclysis, radiograph) located the capsule still in the terminal ileum proximal to an inflamed stenosis. Corticosteroids were subscribed for 4 weeks, but the capsule stayed in place. Surgery was discussed, but denied by the patient. Finally, the capsule could be taken out by double balloon enteroscopy.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Capsule Endoscopy / adverse effects*
  • Crohn Disease / complications
  • Crohn Disease / diagnosis*
  • Foreign Bodies / complications*
  • Foreign Bodies / therapy
  • Gastrointestinal Hemorrhage / etiology*
  • Humans
  • Ileum*
  • Male
  • Recurrence
  • Treatment Outcome