What have we learned from 5 cases of permanent capsule retention

Background Capsule endoscopy allows the direct visualization of the entire small bowel. However, there are limited data on the clinical significance of permanent capsule retention. Method We report on a case series of 5 patients with permanent capsule retention in 245 consecutive cases of capsule endoscopy analyzed retrospectively. Results Permanent capsule retention occurred in 2% of our cases (5/245). The following pathologies had caused insufficient capsule passage: adenocarcinoma in a patient with hereditary nonpolyposis colorectal cancer (1), idiopathic stenosis (1), stricturing Crohn's disease (2), and adhesions (1). Only in one of these cases did capsule retention lead to a symptomatic small-bowel obstruction (0.4%). As a consequence, 2 cases had successful endoscopic retrieval; 3 cases required surgical intervention. Four of 5 patients had a clear clinical benefit resulting from the capsule findings or the secondary procedure. Conclusions Permanent capsule retention is rare. Even though this event may lead to the necessity of an endoscopic or surgical intervention, a clear benefit for the patient in respect to the underlying disease resulted in 4 of 5 of our patients.