Open AccessIncidental Small Bowel Adenocarcinoma Upon Surgical Evaluation of a Retained Endoscopic Video Capsule in a Patient With Crohn’s Disease
Author(s) -
Mahmoud Aryan,
Nabeel Moon
Publication year - 2021
Publication title -
gastroenterology research
Language(s) - English
Resource type - Journals
eISSN - 1918-2813
pISSN - 1918-2805
DOI - 10.14740/gr1403
Subject(s) - medicine , capsule , hematochezia , esophagogastroduodenoscopy , colonoscopy , ileocecal valve , capsule endoscopy , abdominal pain , surgery , cecum , crohn's disease , adenocarcinoma , radiology , gastroenterology , disease , ileum , colorectal cancer , cancer , endoscopy , botany , biology
A 28-year-old male with Crohn's disease presented with hematochezia and severe anemia. Upon evaluation, no source of bleeding was identified with colonoscopy or esophagogastroduodenoscopy; therefore, a video capsule was placed. Following capsule placement, the patient developed severe abdominal pain. Abdominal X-ray revealed the capsule at the ileocecal valve, indicating it was possibly stuck in a stricture. To reduce inflammation, intravenous steroids were started to assist with capsule passage. Following unsuccessful passage and continual abdominal pain, surgical investigation visualized a mass arising from a jejunal Crohn's stricture. Despite multiple inspections of the resected small bowel, the capsule was not located. Intraoperative X-ray revealed the capsule inside the large bowel, indicating capsule passage through the stricture. Final pathology revealed metastatic poorly differentiated adenocarcinoma. This case demonstrates management of a retained capsule in Crohn's patients and emphasizes the importance of considering small bowel adenocarcinoma in Crohn's patients with obstructive signs.