P290 Evaluation of patients with retained patency capsule
Silva M., Cardoso H., Peixoto A., Marques M., Nunes A.C.-R., Lopes S., Magro F., Macedo G.
Centro Hospitalar São João, Department of Gastroenterology, Porto, Portugal
Capsule endoscopy (CE) is a non-invasive method for examining the small bowel. Nevertheless capsule retention is the most significant complication of these devices and may occur in any location of the gastrointestinal tract. Patency capsule (PC) was developed to avoid this risk of capsule retention. The aim of this study was to characterize the patients that presented PC retention.
Retrospective study of patients with PC retention between 2010–2014. The main indications for PC were Crohn's disease (CD), subocclusive symptoms, NSAID use or previous abdominal surgery.
Between 2010–2014 there were performed 433 PC, of which 119 (28%) patients had PC retention. The most frequent indication for CE study was CD staging (45%). The 119 patients included were 65% women, mean age 43±17 years, 30% had history of abdominal surgery and the mean follow-up was 20±18 months. Previously, 27% had performed CT/MRI enterography, with bowel wall thickening in 53%, evidence of luminal narrowing/stricture in 28% cases and in 19% no lesions. PC retention was symptomatic in only 5% of patients, all with CD (p=0.006), which was self-limited and resolved without surgery. After negative PC test, other 32% patients performed CT/MRI enterography with bowel wall thickening in 42%, evidence of luminal narrowing/stricture in 18% cases and in 40% no lesions. During follow-up, 9% of patients were submitted to intestinal resection surgery (6 cases of CD, 4 of intestinal neoplasia and 1 of diverticulitis), 3% were diagnosed with small bowel tumor and 2% died from neoplasia related complications.
The PC test has proven to be a safe examination, with reduced frequency of symptomatic retention, which occurred only in patients with CD. Most patients had lesions on CT/MRI enterography study and some needed to perform surgery. The incidence of tumors was relevant and should always be considered in the differential diagnosis.