Case Report
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World J Gastrointest Endosc. Jul 16, 2013; 5(7): 352-355
Published online Jul 16, 2013. doi: 10.4253/wjge.v5.i7.352
Longest duration of retention of video capsule: A case report and literature review
Mukul Bhattarai, Pardeep Bansal, Yakub Khan
Mukul Bhattarai, Internal Medicine Department, Geisinger Medical Center, Danville, PA 17822, United States
Pardeep Bansal, Gastroenterology Department, Geisinger Medical Center, Danville, PA 17822, United States
Pardeep Bansal, Yakub Khan, Gastroenterology Department, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA 18711, United States
Author contributions: Bhattarai M, Bansal P and Khan Y have made substantial contribution for preparation of final paper including drafting of article and designing research; Khan Y performed endoscopy and image diagnosis, also critically analyzed report; Bansal P and Bhattarai M did extensive review of literature and analyzed data; Bhattarai M wrote paper.
Correspondence to: Mukul Bhattarai, MD, Internal Medicine Department, Geisinger Medical Center, 100 N Academy Ave, Danville, PA 17822, United States.
Telephone: +1-570-2716164 Fax: +1-570-2716141
Received: April 8, 2013
Revised: May 15, 2013
Accepted: June 5, 2013
Published online: July 16, 2013

Video capsule endoscopy (VCE) is a safe innovative tool for investigating obscure gastrointestinal bleeding, Crohn’s disease and other small bowel pathologies. The capsule is usually excreted with faeces within 24-48 h. Retention of capsule rarely occurs, and it usually depends on the indication of VCE. The longest reported case of capsule retention in the literature is 2.5 years. Surgical approach is considered effective to retrieve the retained capsule. We present a case of asymptomatic retention of capsule for four and half years in a 49-year-old man who underwent VCE to explore the cause of obscure gastrointestinal bleeding. It was successfully retrieved endoscopically. We will also briefly review the literature regarding the causes, different presentations and management of capsule retention.

Keywords: Video capsule endoscopy, Obscure gastrointestinal bleeding, Capsule retention, Crohn’s disease, Enteropathy

Core tip: We present the longest case of asymptomatic video capsule retention in the literature. With our case we would like to highlight that asymptomatic video capsule retention is not an indication for surgical retrieval. Capsule can retain for long time without harm. Surgical retrieval should be reserved for those patients in whom the expectant management, medical management and endoscopic therapy fails or in patients who are symptomatic with intestinal obstruction or perforation.