ICCE Consensus for Capsule Retention

Capsule endoscopy allows direct examination of the entire length of the small bowel in a noninvasive manner and has become the gold standard in evaluating suspected disease of the small bowel 1 2. Capsule retention remains a major concern for physicians performing capsule endoscopy, since it was postulated that retention could cause acute small-bowel obstruction and, even without obstruction, retention could lead to a need for surgery to remove the capsule. Thus, retention could theoretically lead to surgery in a patient who otherwise might have been treated medically for the same illness. This is especially felt to be true for patients with Crohn’s disease or nonsteroidal anti-inflammatory drug (NSAID) enteropathy. The working group reviewed the available published data on capsule endoscopy to determine the true incidence of retention and the reported incidence of acute capsule impaction leading to obstruction. From a review of these data, the working group devised a statement to guide physicians with regard to retention.