Spontaneous passage of a retained endoscopic capsule prior to scheduled surgery in a Crohn’s disease patient: A case report

Abstract

Background

Video capsule endoscopy (VCE) is a noninvasive tool used to evaluate small bowel diseases, including Crohn’s disease, suspected small bowel bleeding, malabsorption, and chronic diarrhea. A known complication is capsule retention (CR), particularly in patients with established Crohn’s disease and undetected strictures. While CR often requires endoscopic or surgical removal, spontaneous passage has been reported following medical therapy.

Case summary

We present the first documented case in Sudan of a 28-year-old male with Crohn’s disease who experienced capsule retention, followed by spontaneous passage. The patient had a 7-year history of chronic diarrhea, weight loss, and post-defecation abdominal pain. Initial imaging and endoscopy were inconclusive. A small bowel follow-through confirmed luminal patency, and VCE was performed, revealing classic Crohn’s features and suggesting a terminal ileal stricture. Two weeks later, X-ray showed the capsule retained in the right colon, and surgery was planned. However, a follow-up radiograph before surgery confirmed spontaneous passage, likely aided by corticosteroid and mesalamine therapy.

Conclusion

This case underscores the importance of evaluating for strictures before VCE in Crohn’s patients. Conservative treatment may promote capsule passage in selected cases, avoiding invasive intervention. Use of patency capsules and cross-sectional imaging is recommended to minimize retention risk.