Retrieval of a retained capsule endoscopy through a metallic colonic stent in a patient with a neoplastic obstruction

Abstract

We present a case of a 77-year-old woman with a history of iron-deficiency anemia. An upper GI endoscopy and colonoscopy were performed in 2019 without significant findings other than colonic diverticula. A year later, a small bowel capsule endoscopy (SBCE) ruled out any pathological lesions in the small bowel, reaching the cecum without complications. However, one month after ingestion of SBCE the patient was admitted to the emergency department due to nausea, abdominal bloating and tenderness. Abdominal CT-Scan revealed a stenosis in the descending colon with an image of a metallic foreign body consistent with a retained capsule and important dilation of the proximal colon (Fig. 1A). A colonoscopy was performed showing a stenotic mucosal lesion that was suspicious for colonic neoplasia located at 50 cm from the anal verge. Multiple biopsies were taken. Afterwards, a self-expandable metal colonic stent of 90 mm × 25 mm was deployed under radiologic and endoscopic control (Fig. 1B, C) resulting in the drainage of fecal material and solving the obstructive syndrome. SBCE was successfully retrieved under radiologic control using a polypectomy snare through the metal stent (Fig. 1D). Finally, the patient was discharged. Pathological reports confirmed a colorectal adenocarcinoma and the patient is currently awaiting for oncologic surgery.