Manejo no quirúrgico de pacientes sintomáticos con cápsula endoscópica retenida en enfermedad de Crohn
DOI:
https://doi.org/10.30944/20117582.362Palabras clave:
endoscopía capsular, enfermedades inflamatorias intestinales, enfermedad de Crohn, complicacionesResumen
Introducción. La enfermedad de Crohn es una enfermedad crónica del sistema gastrointestinal, que produce múltiples complicaciones a lo largo de su presentación clínica, lo cual hace difícil su diagnóstico y abordaje terapéutico. Objetivo. El objetivo del estudio fue describir las opciones diagnósticas y terapéuticas en la enfermedad de Crohn, en casos que cursan con cápsula endoscópica retenida; se presentan dos casos y el resultado de su manejo no operatorio. Materiales y métodos. Se tomaron los datos de la historia clínica de dos pacientes y se analizaron los datos clínicos y las ayudas diagnósticas utilizadas. Se describieron los hallazgos y el enfoque terapéutico, y se hizo una revisión de la literatura científica sobre el tema. Resultados. Dos pacientes con enfermedad de Crohn presentaron retención sintomática de la cápsula endoscópica. Se manejaron con éxito, sin tenerse que practicar ninguna intervención quirúrgica, como indica la mayoría de los informes en presencia de síntomas y signos de obstrucción gastrointestinal. Conclusiones. La retención de la cápsula endoscópica es poco frecuente y su manejo a lo largo de la historia ha sido la cirugía como primera elección, en aquellos pacientes que presentan signos y síntomas de obstrucción intestinal. Sin embargo, con el pasar de los años se han practicado diferentes técnicas terapéuticas, como las endoscópicas y médicas, las cuales han sido exitosas y con pocas complicaciones, en comparación con el tratamiento quirúrgico tradicional.
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Referencias bibliográficas
https://doi.org/10.1016/j.crohns.2007.11.003
2. Gay G, Delvaux M. Double balloon enteroscopy in Crohn's disease and related disorders: Our experience. Gastrointest Endosc. 2007;66:S82-90.
https://doi.org/10.1016/j.gie.2007.06.036
3. Oshitani N, Yukawa T, Yamagami H, Inagawa M, Kamata N, Watanabe K, et al. Evaluation of deep small bowel involvementby double-balloon enteroscopy in Crohn's disease. Am J Gastroenterol. 2006;101:1484-9.
https://doi.org/10.1111/j.1572-0241.2006.00648.x
4. Costamagna G, Shah SK, Riccioni ME, Foschia F, Mutignani M, Perri V, et al. A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease. Gastroenterology. 2002;123:999-1005.
https://doi.org/10.1053/gast.2002.35988
5. Eliakim R, Suissa A, Yassin K, Katz D, Fischer D. Wireless capsule video endoscopy compared to barium follow-through and computerized tomography in patients with suspected Crohn's disease final report. Dig Liver Dis. 2004;36:519-22.
https://doi.org/10.1016/j.dld.2004.03.011
6. Fireman Z, Mahajna E, Broide E, Shapiro M, Fich L, Sternberg A, et al. Diagnosing small bowel Crohn's disease with wireless capsule endoscopy. Gut. 2003;52:390-2.
https://doi.org/10.1136/gut.52.3.390
7. Herrerías JM, Caunedo A, Rodríguez-Téllez M, Pellicer F, Herrerías JM Jr. Capsule endoscopy in patients with suspected Crohn's disease and negative endoscopy. Endoscopy. 2003;35:564-8.
https://doi.org/10.1055/s-2003-40241
8. Albert JG, Martiny F, Krummenerl A, Stock K, Lesske J, Göbel CM, et al. Diagnosis of small bowel Crohn's disease: A prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis. Gut. 2005;54:1721-7.
https://doi.org/10.1136/gut.2005.069427
9. Galiano MT, Cepeda R, García F. Experiencia clinica del uso de la videocápsula endoscópica en el diagnóstico de patología del intestino delgado. Rev Colomb Gastroenterol. 2009;24:17-25.
10. Galiano, MT, Cepeda R, García F. Angiodisplasias de intestino delgado, presentación de dos casos. Rev Colomb Gastroenterol. 2004;19:269-76.
11. Cave D, Legnani P, de Franchis R, Lewis BS. ICCE consensus for capsule retention. Endoscopy. 2005;37:1065-7.
https://doi.org/10.1055/s-2005-870264
12. Li F, Gurudu SR, De Petris G, Sharma VK, Shiff AD, Heigh RI, et al. Retention of the capsule endoscope: A single-center experience of 1000 capsule endoscopy procedures. Gastrointest Endosc. 2008;68:174-80.
https://doi.org/10.1016/j.gie.2008.02.037
13. Ho K, Joyce AM. Complications of capsule endoscopy. Gastrointest Endosc Clin N Am. 2007;17:169-78.
https://doi.org/10.1016/j.giec.2006.11.001
14. Pennazio M, Santucci R, Rondonotti E, Abbiati C, Beccari G, Rossini FP, et al. Outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy: Report of 100 consecutive cases. Gastroenterology. 2004;126:643-53.
https://doi.org/10.1053/j.gastro.2003.11.057
15. Sears DM, Avots-Avotins A, Culp K, Gavin MW. Frequency and clinical outcome of capsule retention during capsule endoscopy for GI bleeding of obscure origin. Gastroint Endosc. 2004;60:822-7.
https://doi.org/10.1016/S0016-5107(04)02019-X
16. Buchman AL, Miller FH, Wallin A, Chowdhry AA, Ahn C. Videocapsule endoscopy versus barium contrast studies for the diagnosis of Crohn's disease recurrence involving the small intestine. Am J Gastroenterol. 2004;99:2171-7.
https://doi.org/10.1111/j.1572-0241.2004.40253.x
17. Xin L, Liao Z, Du YQ, Jiang YP, Li ZS. Retained capsule endoscopy causing intestinal obstruction - Endoscopy retrieval by retrograde single-ballon enteroscopy. J Interv Gastroenterol. 2012;2:15-8.
https://doi.org/10.4161/jig.20128
18. Liao Z, Gao R, Xu C, Li ZS. Indications and detection, completion, and retention rates of small-bowel capsule endoscopy: A systematic review. Gastrointest Endosc. 2010;71:280-6.
https://doi.org/10.1016/j.gie.2009.09.031
19. Cheifetz AS, Kornbluth AA, Legnani P, Schmelkin I, Brown A, Lichtiger S, et al. The risk of retention of the capsule endoscope in patients with known or suspected Crohn's disease. Am J Gastroenterol. 2006;101:2218-22.
https://doi.org/10.1111/j.1572-0241.2006.00761.x
20. Rondonotti E, Herrerias JM, Pennazio M, Caunedo A, Mascarenhas- Saraiva M, de Franchis R. Complications, limitations, and failures of capsule endoscopy: A review of 733 cases. Gastrointest Endosc. 2005;62:712-6.
https://doi.org/10.1016/j.gie.2005.05.002
21. May A, Manner H, Schneider M, Ipsen A, Ell C. Prospective multicenter trial of capsule endoscopy in patients with chronic abdominal pain, diarrhea and other signs and symptoms (CEDAPPlus Study). Endoscopy. 2007;39:606-12.
https://doi.org/10.1055/s-2007-966640
22. Hyun JH, Keum BR, Choung RS, Kim YS, Jeen YT, Chun HJ, et al. Analysis of incomplete small bowel investigation in capsule endoscopy. Gastrointest Endosc. 2004;59:177.
https://doi.org/10.1016/S0016-5107(04)00839-9
23. Shim KN, Kim YS, Kim KJ, Kim YH, Kim TI, Do JH, et al. Abdominal pain accompanied by weight loss may increase the diagnostic yield of capsule endoscopy: A Korean multicenter study. Scand J Gastroenterol. 2006;41:983-8.
https://doi.org/10.1080/00365520600548974
24. González P, Picazo J, Fernández S, Pérez F, Roncero O. Intestinal perforation due to retained wireless capsule endoscope. Endoscopy. 2005;37:684.
https://doi.org/10.1055/s-2005-861424
25. Lin OS, Brandabur JJ, Schembre DB, Soon MS, Kozarek RA. Acute symptomatic small bowel obstruction due to capsule impaction. Gastrointest Endosc. 2007;65:725-8.
https://doi.org/10.1016/j.gie.2006.11.033
26. Repici A, Barbon V, De Angelis C, Luigiano C, De Caro G, Hervoso C, et al. Acute small-bowel perforation secondary to capsule endoscopy. Gastrointest Endosc. 2008;67:180-3.
https://doi.org/10.1016/j.gie.2007.05.044
27. Aguirre D, Archila P, Carrera J, Castaño R, Escobar C, Duperty R. Consenso Colombiano de Enfermedad Inflamatoria Intestinal. Rev Colomb Gastroenterol. 2012;27:s2-44.
28. O'Donnell S, Qasim A, Ryan BM, O'Connor HJ, Breslin N, O'Morain CA. The role of capsule endoscopy in small bowel Crohn's disease. J Crohns Colitis. 2009;3:282-6.
https://doi.org/10.1016/j.crohns.2009.07.002
29. Cheifetz AS, Lewis BS. Capsule endoscopy retention: Is it a complication? J Clin Gastroenterol. 2006;40:688-91.
https://doi.org/10.1097/00004836-200609000-00005
30. Mow WS, Lo SK, Targan SR, Dubinsky MC, Treyzon L, Abreu-Martin MT, et al. Initial experience with wireless capsule enteroscopy in the diagnosis and management of inflammatory bowel disease. Clin Gastroenterol Hep. 2004;2:31-40.
https://doi.org/10.1016/S1542-3565(03)00289-1
31. Yacoub JH, Oto A. New magnetic resonance imaging modalities for Crohn disease. Magn Reson Imaging Clin N Am. 2014;22:35-50.
https://doi.org/10.1016/j.mric.2013.07.005
32. Horsthuis K, Bipat S, Bennink RJ, Stoker J. Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: Metaanalysis of prospective studies. Radiology. 2008;247:67-79.
https://doi.org/10.1148/radiol.2471070611
33. Delvaux M, Ben Soussan E, Laurent V, Lerebours E, Gay G. Clinical evaluation of the use of the M2A patency capsule system before a capsule endoscopy procedure, in patients with known or suspected intestinal stenosis. Endoscopy. 2005;37:801-7.
https://doi.org/10.1055/s-2005-870241
34. Spada C, Spera G, Riccioni M, Biancone L, Petruzziello L, Tringali A, et al. A novel diagnostic tool for detecting functional patency of the small bowel: The given patency capsule. Endoscopy. 2005;37:793-800.
https://doi.org/10.1055/s-2005-870246
35. Boivin M, Lochs H, Voderholzer W. Does passage of the patency capsule indicate small bowel patency? Endoscopy. 2005;37:808-15.
https://doi.org/10.1055/s-2005-870220
36. Banerjee R, Bhargav P, Reddy P, Gupta R, Lakhtakia S, Tandan M, et al. Safety and efficacy of the M2A patency capsule for diagnosis of critical intestinal patency: Results of a prospective clinical trial. J Gastroenterol Hepatol. 2007;22:2060-3.
https://doi.org/10.1111/j.1440-1746.2007.05039.x
37. Spada C, Shah SK, Riccioni ME, Spera G, Marchese M, Iacopini F, et al. Video capsule endoscopy in patients with known or suspected small bowel stricture previously tested with the dissolving patency capsule. J Clin Gastroenterol. 2007;41:576-82.
https://doi.org/10.1097/01.mcg.0000225633.14663.64
38. Li F, Gurudu SR, De Petris G, Sharma VK, Shiff AD, Heigh RI, et al. Retention of the capsule endoscope: A single-center Rev Colomb Cir. 2015;30:203-11 Manejo medico de cápsula retenida 211 experience of 1000 capsule endoscopy procedures. Gastrointestinal Endoscopy. 2008;68:174-80.
https://doi.org/10.1016/j.gie.2008.02.037
39. Höög CM, Bark LÅ, Arkani J, Gorsetman J, Broström O, Sjöqvist U. Capsule retentions and incomplete capsule endoscopy examinations: An analysis of 2300 examinations. Gastroenterology Research and Practice. 2012;518718.
https://doi.org/10.1155/2012/518718
40. Karagiannis S, Faiss S, Mavrogiannis C. Capsule retention: A feared complication of wireless capsule endoscopy. Scand J Gastroenterology. 2009;44:1158-65.
https://doi.org/10.1080/00365520903132039
41. Tanaka S, Mitsui K, Shirakawa K, Tatsuguchi A, Nakamura T, Hayashi Y, et al. Successful retrieval of video capsule endoscopy retained at ileal stenosis of Crohn's disease using double balloon endoscopy. J Gastroenterol Hepatol. 2006;21:922-3.
https://doi.org/10.1111/j.1440-1746.2006.04120.x
42. Tashiro Y, Kawai M, Takehara K, Munakata S, Ishiyama S, Sugimoto K, et al. Successful retrieval of a retained capsule endoscope with single incision laparoscopic surgery. Case Rep Gastroenterol. 2014;8:206-10.
https://doi.org/10.1159/000364821
43. Domínguez EP, Choi Y, Raijman IL, Sweeney JF. Laparoscopic approach for the retrieval of retained video capsule endoscopy. JSLS. 2006;10:496-8.
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