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

• Ignacio Fernández-Urien ^[6] ; Cristina Carretero ^[1] ; Begoña González ^[7] ; Vicente Pons ^[8] ; Ángel Caunedo ^[2] ; Julio Valle ^[5] ; Eduardo Redondo-Cerezo ^[9] ; Antonio López-Higueras ^[10] ; Mariano Valdés ^[11] ; Pedro Menchen ^[3] ; Pedro Fernández ^[4] ; Miguel Muñoz-Navas ^[1] ; Javier Jiménez ^[6] ; Juan Manuel Herrerías ^[2]
  1. [1] Universidad de Navarra

     Universidad de Navarra

     Pamplona, España

     
  2. [2] Hospital Universitario Virgen Macarena

     Hospital Universitario Virgen Macarena

     Sevilla, España

     
  3. [3] Hospital General Universitario Gregorio Marañón

     Hospital General Universitario Gregorio Marañón

     Madrid, España

     
  4. [4] Hospital Universitario Marqués de Valdecilla

     Hospital Universitario Marqués de Valdecilla

     Santander, España

     
  5. [5] Complejo Hospitalario de Toledo

     Complejo Hospitalario de Toledo

     Toledo, España

     
  6. [6] Complejo Hospital de Navarra. Pamplona
  7. [7] Hospital Clínic. Barcelona
  8. [8] Hospital Universitario y Politécnico La Fe. Valencia
  9. [9] Hospital Virgen de las Nieves. Granada
  10. [10] Hospital General Universitario Morales Messeguer. Murcia
  11. [11] Hospital Universitario Virgen de la Arrixaca

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• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 107, Nº. 12, 2015, págs. 745-752
• Idioma: inglés
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  • 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.